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

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Abstract

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 ≥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.

Résumé

Le propos de cette étude est d’explorer les facteurs influençant la durée moyenne de séjour des prothèses totales de hanche et des prothèses totales du genou. Cette étude a analysé 37 918 prothèses totales de hanches et 76 727 prothèses totales du genou, réalisées à Taiwan de 1996 à 2004. Les facteurs suivants étaient associés à une augmentation de la durée de séjour: un âge inférieur à 65 ans. L’indice de sévérité des lésions CCI = 1 ou ≥2, l’absence de diagnostic primaire (coxarthrose, arthrite rhumatoïde, nécrose) le traitement dans un hôpital ou par un praticien réalisant de gros volumes opératoires, la longueur de l’ALOS. Le Bureau Central d’Assurance BNHI demande que les praticiens prennent les mesures nécessaires pour diminuer le nombre de complications et augmenter la qualité de vie après l’intervention. L’utilisation de prothèses de différents fabricants permet de réduire les coûts sans compromettre la satisfaction des patients.

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Acknowledgments

This work was supported by a grant (NSC 96–2314-B-037–050-MY3) from the National Science Council in Taiwan.

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Authors and Affiliations

  1. Graduate Institute of Healthcare Administration, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung, 807, Taiwan

    Wei-Che Tien, Herng-Chia Chiu, King-Teh Lee & Hon-Yi Shi

  2. Department of Information Management, National Sun Yat-Sen University, Kaohsiung, Taiwan

    Hao-Yun Kao

  3. Department of Orthopaedics, E-Da Hospital, Kaohsiung, Taiwan

    Yuan-Kun Tu

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  1. Wei-Che Tien
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  2. Hao-Yun Kao
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  3. Yuan-Kun Tu
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  4. Herng-Chia Chiu
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  5. King-Teh Lee
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  6. Hon-Yi Shi
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Correspondence to Hon-Yi Shi.

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Tien, WC., Kao, HY., Tu, YK. et al. A population-based study of prevalence and hospital charges in total hip and knee replacement. International Orthopaedics (SICOT) 33, 949–954 (2009). https://doi.org/10.1007/s00264-008-0612-1

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  • DOI: https://doi.org/10.1007/s00264-008-0612-1

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