Medico-Economic Considerations: Money Does Not Buy Happiness
Hip arthritis is one of the most disabling diseases in the world. The World Health Organisation (WHO) estimates half a million total hip replacements per annum in 2030. Health care systems around the world differ but all have a common need to spend limited resources wisely. There is an intrinsic confl ict between science and economy. The stakeholders include: patients, surgeons, hospitals, payers and manufactures. In the UK, the Primary Care Trust defi nes the tariff for a hip replacement and all other medical procedures. Piers Yates states that the Corail® stem is more expensive than the cemented Exeter stem, but cheaper than the cemented C-stem, when taking all costs involved into account. High performance total hip replacements are usually most expensive, for example a Corail® stem, a cementless press-fi t cup and a ceramic on ceramic articulation. However, approximately 1,500 USD can be saved when using an early discharge programme and in the longer term much greater savings can be made with the reduced costs for repeat revision surgery for all reasons. The newest and the most expensive implants are not necessarily the best. The whole package of a total hip arthroplasty (THA) procedure must be taken into account and valued against expensive implants. Regular follow-up is mandatory for future decision taking.
KeywordsDiameter Head Metal Head National Joint Registry Advanced Bearing Disable Disease
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