A population-based study of prevalence and hospital charges in total hip and knee replacement

• DOI: 10.1007/s00264-008-0612-1
• Publication Date: 2008-07-08T06:48:01Z
• Authors: Wei-Che Tien; Hao-Yun Kao; Yuan-Kun Tu; Herng-Chia Chiu; King-Teh Lee; Hon-Yi Shi
• Keywords: Adult; Aged, 80 and over; Male; Arthroplasty, Replacement, Hip; Age Factors; Osteonecrosis; Taiwan; Middle Aged; Osteoarthritis, Knee; Severity of Illness Index; Osteoarthritis, Hip; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Prevalence; Humans; Regression Analysis; Female; Hospital Costs; Arthroplasty, Replacement, Knee; Aged; Retrospective Studies

The purpose of this study was to explore the increasing prevalence of factors affecting hospital charges for primary total hip replacement/total knee replacement (THR/TKR). This study analysed 37,918 THR and 76,727 TKR procedures performed in Taiwan from 1996 to 2004. Odds ratio (OR) and effect size (ES) were calculated to assess the relative change rate. Multiple regression models were employed to predict hospital charges. The following factors were associated with increased hospital charges: age younger than 65 years old; increased disease severity (Charlson comorbidity index [CCI] = 1 or > or = 2); absence of primary diagnoses of osteoarthritis (OA), rheumatoid arthritis (RA), avascular necrosis (AVN); treatment at a hospital or by a surgeon performing a high volume of operations; and longer average length of stay (ALOS). The Bureau of National Health Insurance (BNHI) should ensure that surgeons take precautionary measures to minimise complications and maximise quality of life after surgery. Use of joint prostheses from different manufacturers can reduce costs without compromising patient satisfaction.