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THE CROATIAN HEALTH INSURANCE FUND DOES NOT RECOGNIZE DIFFERENCES IN THE COST OF DIFFERENT TREATMENTS FOR REVISION

Srećko Sabalić1, Dinko Vidović1, Slaven Babić1

  • 11Department of Traumatology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2School of Medicine, University of Split, Split, Croatia; 3School of Dental Medicine, University of Zagreb, Zagreb, Croatia; 4University of Applied Health Sciences, Zagreb, Croatia; 5School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 6Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.

Acta Clinica Croatica
|July 21, 2021
PubMed

Insights

Revision hip arthroplasty (THA) is costly, especially for infections. Current health insurance reimbursements are inadequate and do not cover the actual treatment costs for revision THA, impacting healthcare providers.

Area of Science:

  • Orthopedic Surgery
  • Health Economics
  • Medical Device Technology

Background:

  • Revision total hip arthroplasty (THA) interventions incur significant treatment costs.
  • Infection is a major factor contributing to the high expense of revision THA.
  • Existing literature highlights the financial burden associated with revision arthroplasty.

Purpose of the Study:

  • To compare treatment costs and health insurance reimbursements for revision THA.
  • To analyze financial differences between revision THA for infection versus aseptic indications (instability, fracture).

Main Methods:

  • Analysis of hospital data for 168 patients undergoing revision THA (2010-2018).
  • Financial data collected from Hospital Information System, including total cost per patient, implant costs, and length of stay.
  • Comparison of total costs against Croatian Health Insurance Fund reimbursements.

Main Results:

  • The Croatian Health Insurance Fund reimbursement does not differentiate costs for aseptic instability, infection, or periprosthetic fracture.
  • Mean cost differences per patient were -262.83 € (aseptic instability), -1694.94 € (infection), and -916.49 € (periprosthetic fracture).
  • Reimbursements were found to be inadequate for centers performing revision hip surgery.

Conclusions:

  • Current health insurance reimbursement structures are insufficient for the actual costs of revision THA.
  • The financial model does not account for the increased complexity and cost associated with infected revision hip arthroplasty.
  • Policy review is needed to ensure adequate reimbursement for revision hip surgery to maintain quality of care.

Keywords:
Aseptic instabilityFinancial analysisInfectionPeriprosthetic fractureRevision total hip arthroplasty

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