Introduction
Patients and methods
Population
Treatment and follow-up
Cost measurement
Cost categories | Unit | Source of consumption data | Source of value | Unit price (€) |
---|---|---|---|---|
Hospital costs—primary stay | ||||
Emergency department visit | Visit | Hospital registry | Cost manuala
| 160.34 |
Radiology/diagnostic modalities | ||||
X-ray | X-ray | Hospital registry | NZab
| 54.14 |
CT-scan pelvis | CT-scan | Hospital registry | NZab
| 238.25 |
MRI scan pelvis | MRI scan | Hospital registry | NZab
| 274.16 |
Ultrasound | Ultrasound | Hospital registry | NZab
| 86.07 |
DEXA scan | DEXA scan | Hospital registry | NZab
| 114.52 |
Skeletal scintigraphy | Scintigraphy | Hospital registry | NZab
| 194.37 |
Surgery | ||||
Surgeon | Hour | Study registry (CRF) | Cost manuala
| 143.88c/109.37d
|
Operating roome
| Hour | Study registry (CRF) | Hospital/industry dataf
| 738.60c/885.00d
|
Equipment and implant | ||||
Cemented hemiarthroplasty | Operation | Study registry (CRF) | Hospital/industry dataf
| 1362.00c/1197.73d
|
Cemented total hip arthroplasty | Operation | Study registry (CRF) | Hospital/industry dataf
| 1465.75c/1684.45d
|
Uncemented total hip arthroplasty | Operation | Study registry (CRF) | Hospital/industry dataf
| NA/2041.80d
|
Admission days | Day | Study registry (CRF) | Cost manuala
| 610.57c/461.91d
|
Hospital costs—follow-up | ||||
Radiology/diagnostic modalities | As described above | |||
Outpatient clinic visits | Visit | Hospital registry + questionnaireg
| Cost manuala
| 136.98c/67.96d
|
Adverse events | ||||
Medicationh
| Dose per day | Hospital registry/questionnaireg
| CVZi
| Variable |
Emergency | Visit | Hospital registry | Cost manuala
| 160.34 |
Brace | Piece | Hospital registry/questionnaireg
| Hospital/industry dataf
| 440.39 |
Admission days | Day | Study registry (CRF) | Cost manuala
| 610.57c/461.91d
|
Revision surgery | ||||
Surgeon | Hour | Study registry (CRF) | Cost manuala
| 143.88c/109.37d
|
Operating roome
| Hour | Study registry (CRF) | Hospital/industry dataf
| 738.60c/885.00d
|
Equipment and implant | ||||
Cemented hemiarthroplasty | Operations | Study registry (CRF) | Hospital/industry dataf
| 1362.00c/1197.73d
|
Cemented total hip arthroplasty | Operations | Study registry (CRF) | Hospital/industry dataf
| 1465.75c/1684.45d
|
Uncemented total hip arthroplasty | Operations | Study registry (CRF) | Hospital/industry dataf
| NA/2041.80d
|
Cup revision | Operations | Study registry (CRF) | Hospital/industry dataf
| 773.09 |
Open fenestration/bursectomy | Operations | Study registry (CRF) | Hospital/industry dataf
| 524.20 |
Open reduction (OR) | Operations | Study registry (CRF) | Hospital/industry dataf
| 333.96 |
Closed reduction (ER) | Operations | Study registry (CRF) | Hospital/industry dataf
| 160.34 |
Antibiotic beads | Operations | Study registry (CRF) | Hospital/industry dataf
| 324.83 |
Admission days | Days | Study registry (CRF) | Hospital/industry dataf
| 610.57c/461.91d
|
Medicationj
| Dose per day | Hospital registry/questionnaireg
| CVZi
| NA |
Costs related to rehabilitation/changes in living situation | ||||
Rehabilitation center/nursing home | ||||
Elderly home | Days | Patient questionnaireg
| Cost manuala
| 95.57 |
Nursing home | Days | Patient questionnaireg
| Cost manuala
| 252.73 |
Rehabilitation clinic | Days | Patient questionnaireg
| Cost manuala
| 361.04 |
Home nursing day | Days | Patient questionnaireg
| Cost manuala
| 46.72 |
Physical therapy (outpatient) | Hour | Patient questionnaireg
| Cost manuala
| |
Physical therapy | Session | Patient questionnaireg
| Cost manuala
| 38.23 |
Use of aids | ||||
Crutches | Day | Patient questionnaireg
| Home care firmk
| 0.07 |
Walker | Day | Patient questionnaireg
| Home care firmk
| 0.08–0.15 |
Wheelchair | Day | Patient questionnaireg
| Home care firmk
| 0.27 |
Electric scooter | Day | Patient questionnaireg
| Home care firmk
| 0.70 |
Extra bed | Day | Patient questionnaireg
| Home care firmk
| 1.22 |
Extra toilet facilities | Day | Patient questionnaireg
| Home care firmk
| 0.10–0.20 |
Extra shower facilities | Day | Patient questionnaireg
| Home care firmk
| 0.10–0.18 |
Statistical analysis
Results
Demographics
Clinical outcome and health care consumption
Revision surgery 1 | Revision surgery 2 | Revision surgery 3 | Revision surgery 4 | |
---|---|---|---|---|
Patient 1 | Conversion to THA | Closed reduction ED | Closed reduction ED | Closed reduction ED |
Patient 2 | Arthrotomy and joint lavage | Arthrotomy and joint lavage | Arthrotomy and joint lavage | |
Patient 3 | Closed reduction ED | Closed reduction ED | Plate fixation periprosthetic frx | |
Patient 4 | Closed reduction OR | Closed reduction ED | ||
Patient 5 | Conversion to THA | |||
Patient 6 | Open reduction | |||
Patient 7 | Closed reduction ED | |||
Patient 8 | Arthrotomy | |||
Patient 9 | Conversion to THA | |||
Patient 10 | Closed reduction OR |
Costs
Cost categories | Cost until 10 weeks (€) | Costs until 1 year (€) | Costs until 2 years (€) |
---|---|---|---|
A) Hospital costs—primary stay | |||
Emergency department visit | 160 (160–160) | 160 (160–160) | 160 (160–160) |
Radiology/diagnostic modalities | 219 (206–232) | 219 (206–232) | 219 (206–232) |
Surgery | 2,915 (2,798–3,023) | 2,915 (2,798–3,023) | 2,915 (2,798–3,023) |
Admission days | 5,732 (4,452–7,966) | 5,732 (4.452–7,966) | 5,732 (4,452–7,966) |
Total | 9,026 (7,706–11,295) | 9,026 (7,706–11,295) | 9,026 (7,706–11,295) |
B) Hospital costs—follow-up | |||
Radiology/diagnostic modalities | 115 (103–128) | 240 (212–270) | 344 (278–427) |
Outpatient clinic visits | 120 (109–133) | 297 (263–336) | 416 (355–494) |
Adverse events | 200 (66–392) | 581 (280–1,056) | 1,052 (568–1,781) |
Revision surgery | 396 (61–990) | 480 (112–1,100) | 980 (345–1,940) |
Medication | 82 (74–92) | 106 (93–121) | 151 (125–182) |
Total | 914 (499–1,541) | 1,705 (1,102–2,563) | 2,943 (1,894–4,308) |
C) Costs related to rehabilitation/changes in living situation | |||
Rehabilitation center/nursing home | 4,707 (3,627–5,874) | 11,694 (8,132–16,350) | 12,240 (8,542–17,008) |
Physical therapy (outpatient) | 549 (470–640) | 1,340 (1,162–1,537) | 1,975 (1,627–2,370) |
Use of aids | 20 (17–25) | 105 (78–139) | 214 (166–270) |
Total | 5,276 (4,200–6,467) | 13,138 (9,486–17,956) | 14,429 (10,461–19,552) |
D) Total costs | 15,216 (13,051–18,323) | 23,869 (19,157–30,136) | 26,399 (21,101–33,213) |