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Financing in knee arthroplasty: a benchmarking analysis

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Flat rate payment and “diagnosis related groups” (DRG) in knee arthroplasty offer incentives to save expenses. A cost-benefit analysis exactly compares all expenses to revenues. This requires patient-related assessment of treatment costs in terms of cost-unit accounting. This study compared expenses of knee arthroplasty in Austrian, German and Swiss clinics.

Materials and methods

A survey of primary and revision surgery was conducted and data—divided into cost elements and cost centers—were collected from three Austrian, five German and one Swiss clinic.

Results

Personnel costs for medical services were lower in Austria (€ 617) than Germany (€ 1,271) and Switzerland (€ 1,305). Nursing costs amounted to € 1,432 in Austria, € 1,011 in Germany, € 2,525 in Switzerland. Costs for med.-tech. services were lower in Austria (€ 261) than Germany (€ 848) and Switzerland (€ 1,093). Average costs for medication amounted to € 491 in Austria, higher than Germany (€ 118), lower than Switzerland (€ 506). Costs for implants were higher in Austria (€ 2,558) than Germany (€ 2,134), highest in Switzerland (€ 3,619). Regarding case numbers, these cost elements showed significant differences (P< 0.001). Costs for non-medical goods were similar (Austria € 478, Germany € 427, Switzerland € 488). Personnel and material infrastructure was higher in Austria (€ 516) than Germany (€ 360); € 1,658 in Switzerland. Administration was much higher in Austria (€ 2,330) than Germany (€ 1,461) and Switzerland (€ 1,431). Costs for primary knee arthroplasty amounted to € 8,684 in Austria, € 7,631 in Germany, € 12,625 in Switzerland.

Conclusions

The proportion for personnel costs (medical, nursing, med.-tech.) of total costs was higher in Germany (41%) than Austria (26.6%) and Switzerland (39.9%). Implant costs were proportionally nearly the same in Austria (29.5%) than Germany (28%) and Switzerland (28.7%). Administration was proportionally higher in Austria (26.8%) than Germany (19.1%) and Switzerland (11.3%). To lower the costs, the expenses for personnel and implants must be reduced. Ultimately, the potential for hospitals to save costs can be found here.

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Notes

  1. Personal communication Dr. Drauschke, GÖK Consulting Berlin.

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Acknowledgments

The authors want to thank Elmar Kißlinger, MD, Bad Abbach for his statistical analysis and graphic records.

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Authors and Affiliations

  1. Orthopaedic University Hospital Friedrichsheim, Marienburgstraße 2, 60528, Frankfurt a. M, Germany

    Harald Effenberger

  2. Orthopaedic Department, Markus-Hospital, Wilhelm Epstein Str. 2, 60431, Frankfurt a. M, Germany

    Stefan Rehart

  3. Orthopaedic Department, Kantonsspital Aarau AG, Tellstraße, 5001, Aarau, Switzerland

    Marc D. Zumstein

  4. Research Unit, Klinikum Neumarkt, Nürnbergerstr. 12, 92318, Neumarkt i . Opf, Germany

    Alexander Schuh

  5. Rossmarkt 25, 4710, Grieskirchen, Austria

    Harald Effenberger

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  1. Harald Effenberger
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  2. Stefan Rehart
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  4. Alexander Schuh
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Correspondence to Harald Effenberger.

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Effenberger, H., Rehart, S., Zumstein, M.D. et al. Financing in knee arthroplasty: a benchmarking analysis. Arch Orthop Trauma Surg 128, 1349–1356 (2008). https://doi.org/10.1007/s00402-008-0570-5

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  • DOI: https://doi.org/10.1007/s00402-008-0570-5

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