[Total knee and hip prosthesis: variables associated with costs]

Area of Science:

• Orthopedics
• Health Economics
• Healthcare Management

Background:

• Osteoarthritis prevalence is high in Western countries, leading to significant healthcare costs associated with hip and knee arthroplasty.
• Wide variations in clinical practice for arthroplasty surgeries necessitate cost comparisons.
• Understanding pre- and post-surgery costs is crucial for healthcare resource management.

Purpose of the Study:

• To investigate the factors influencing total knee and hip arthroplasty costs.
• To analyze costs during hospital stay and the first year post-discharge.
• To identify variables affecting patient costs in arthroplasty.

Main Methods:

• A prospective, multi-center study involving 15 hospitals across three Spanish regions.
• Multilevel models were used to analyze relationships between independent variables and costs.
• Variables included patient demographics, preoperative quality of life, surgical type, comorbidities, and hospital characteristics.

Main Results:

• Average hospital stay cost (excluding prosthesis) was €4,734; post-discharge cost was €554.
• Hospital-level variance accounted for 44-46% of total variance in hospital stay costs.
• Hospital-level variance explained 7-9% of the variance in post-discharge costs.

Conclusions:

• Significant potential exists to reduce hospital stay costs for arthroplasty patients.
• Over 44% of cost variability is attributable to hospital practices, not patient clinical factors.
• Optimizing hospital-based cost management strategies can lead to substantial healthcare savings.