Endoscopy At St. Louis Hospital

[CaptHaddock]

My wife had an upset stomach for a couple of days last week. Then blood showed up in her stool and we decided to take her to St. Louis Hospital for an examination. Within 10 minutes of arriving she was talking to a bilingual gastroenterologist and within 15 minutes after that was having an endoscopy. They invited me to watch, which I appreciated. Turns out she has ulcers. The doctor pointed out the lesions to me. After the test he requested her to stay overnight in the hospital to make sure that the blood in her digestive system was not a problem. My wife requested a private room which was large, with a private bathroom. The nurses were very attentive. The doctor visited her each day in her room and explained her condition and treatment. The next day she came home with a couple of prescriptions, diet instructions, and a follow up appointment. We are waiting on the results of a microscope inspection of tissue samples to see if H. pylori is present.

The total cost was ฿30,738, as follows:

room 2880

inpatient meds 4996

iv fluid 570

med supplies 3722

lab investigation & pathology 3020

med equipment 6440

nursing 800

physician procedure 6000

service charge 320

We were pleased with the service. The nurses were friendly and helpful. They certainly did not seem like overworked American nurses with too many patients to care for. When she pressed the call button someone always came within a couple of minutes.

It also seems cheap to me because I have the costs of American medicine in my mind. I don't think she would have been hospitalized even for one night in the US, but I don't really know. Also, in the US I don't believe a procedure like that would not have been available on such short notice unless an emergency.

Does the cost seems appropriate given that it's a private hospital? We understand very well that she could have gone to a government hospital and received good care for much less, but we wanted a private hospital, had been to St. Louis once before, and weren't going to shop around under the circumstances.

[chiang mai]

St Louis has a good reputation although I'm slightly surprised at the cost of the procedure. My most recent endoscopy (up and down) in Chiang Mai cost THB 20k although it did not involve an overnight stay, but that was at CM's most expensive private hospital.

[Sheryl]

If this price is inclusive of the endoscopy, it is much less than ylou'd pay at most private hospitals. i recently priced upper GI endoscopies and done as outpatient they run about 9-10,000 excluding the pathology, so by the time all is said and done you may be out 15,000 baht and that's for an in and put procedure, your wife was admitted.

The medication costs look inflated unless she had IV sedation during the endoscopy. But that is pretty common here.

[CaptHaddock]

If this price is inclusive of the endoscopy, it is much less than ylou'd pay at most private hospitals. i recently priced upper GI endoscopies and done as outpatient they run about 9-10,000 excluding the pathology, so by the time all is said and done you may be out 15,000 baht and that's for an in and put procedure, your wife was admitted.

The medication costs look inflated unless she had IV sedation during the endoscopy. But that is pretty common here.

The endoscopy costs were included and she did have IV sedation.

[Thanyaburi Mac]

Here's what I paid at Vibhavadi Hospital:

10 Nov 2009 Vibhavadi Endoscopy b 11,666 $292.01

Did not spend the night, tho, in and out. IV sedation.

Mac

[Sheryl]

Costs have gone up in the past 2-3 years substantially everyeherre.

i just paid 17,000 baht for endoscopy at Mission Hospital -- but almost 4,000 baht of that was due to the fact that the initial IV sedation had no effect and the anesthesiologist then had to administer a second drug. (I tried to tell her in advance that I am notoriously hard to sedate but of course she didn't listen). So "normal" with IV sedation would have been 13,000 including several thousand for pathology.

The OP's wife was admitted to the hospital for overnight observation of bleeding ulcers so there is considerably more than endoscopy in the charges.

My sister had an outpatient upper endoscopy at St Louis about a year ago, I don't remember exactly but in the region of 10-11K baht with no IV sedation but with path costs.

[Kalbo]

Costs have gone up in the past 2-3 years substantially everyeherre.

i just paid 17,000 baht for endoscopy at Mission Hospital -- but almost 4,000 baht of that was due to the fact that the initial IV sedation had no effect and the anesthesiologist then had to administer a second drug. (I tried to tell her in advance that I am notoriously hard to sedate but of course she didn't listen). So "normal" with IV sedation would have been 13,000 including several thousand for pathology.

The OP's wife was admitted to the hospital for overnight observation of bleeding ulcers so there is considerably more than endoscopy in the charges.

My sister had an outpatient upper endoscopy at St Louis about a year ago, I don't remember exactly but in the region of 10-11K baht with no IV sedation but with path costs.

Very slightly off-topic, but I had an endoscopy in Japan about 15 years ago with no sedation at all, only a some anaesthetic spray on the back of the throat. Never,ever again do I want to go through that.

[rott]

What is the difference between endoscopy and colonoscopy?

[Thanyaburi Mac]

Rott

One goes in the top, one in the bottom...., and the latter is a bit more expensive.

Mac

[rott]

Thanks for that Mac, do they both cover exactly the same areas, if so I suppose the endoscopy is the less unpleasant of the two options.

I have been considering a colonoscopy, is it as uncomfortable as the prostate biopsy?

[chiang mai]

Thanks for that Mac, do they both cover exactly the same areas, if so I suppose the endoscopy is the less unpleasant of the two options.

I have been considering a colonoscopy, is it as uncomfortable as the prostate biopsy?

Get the sleep sedation and the whole thing is aboslutely painless.

[Sheryl]

Thanks for that Mac, do they both cover exactly the same areas, if so I suppose the endoscopy is the less unpleasant of the two options.

No, they cover different areas: upper covers esophagus, stomach and duodenum (the very first part of the small intestine), colonoscopy covers the colon - the large intestine.

Colonocsopy is recommended every 5-10 years for people above a certain age as a means of early detection of colon cancer (sooner/ more often if known risk factors). Gastroscopy (the "upper") is not routinely done, only for people who are symptomatic.

And they are both endoscopies. Which simply means that a tube containing a camera device is inserted allowing direct visualization as well as tissue sampling if needed. Small polyps can also be removed at the same time.

The colonoscopy will always be painless because they will put you to sleep. Some places -- quite a few in fact -- do gastroscopy with only a local anesthetic sprayed into the back of the throat. I can only say that as a nurse who has helped people through that procedure, when it came my time I asked to be knocked out and was willing to pay extra to be. .. .

[rott]

Thanks for that Cheryl, I have since had a colonoscopy at the Sri Sawan hospital in Nakhon Sawan which cost 8,000 baht and showed nothing cancerous, just one small haemorrhoid.

I doubt if the small pile is causing the blood, so will see how much the gastroscopy is.

[Sheryl]

Hemorhoids can cause blood in the stool, even small ones, but the appearance of the blood usually makes it easy to distinguish from an upper gastrointestinal bleed.

Blood from hemorrhoids will be bright red, small in amount and coat the outside of the stool, you may also get some blood streaks on the toilet paper, again brioght red.

Blood from up higher in the intestinal tract will be dark red to black in appearance and may not even be noticeable to the naked eye but will show up on a lab test for occult blood.