Economic burden of knee replacement, a case of Bushehr, Iran in 2023-2024

Joint disorders are diseases or injuries that affect the joints and disrupt their function. When non-surgical treatments do not effectively relieve joint pain and disability, arthroplasty (joint replacement surgery) is performed, with knee replacement surgery being the most common. This study aimed to calculate the economic burden of knee joint replacement surgery in patients referred to hospitals in Bushehr province in 2023-2024.

This cross-sectional study is an economic evaluation that examines the cost of disease from a social perspective. This study was conducted in Bushehr, Iran and included all eligible patients in 2023-2024 as the study population (n = 257). A researcher-made data collection form was used to gather data. A prevalence-based approach and a bottom-up method were employed to calculate costs. Data on direct medical, direct non-medical, and indirect costs were obtained from patients' files, insurance bills, and self-reports from patients or their companions. The human capital approach was used to calculate indirect costs.

The results showed that in 2023-2024, the average total cost per person for knee joint replacement was $10,083.75, with the largest share attributed to direct medical costs, amounting to $8,892.89. The largest components of direct medical cost, direct non-medical cost, and indirect cost were related to joint prosthesis ($4,260), Transportation ($152), and absence from work due to illness ($622.64). Additionally, the average total cost for women was higher than for men ($10,207.56 vs. $10,020.13), and among age groups, the highest average total cost was in those aged 61-70 years, amounting to $10,297.87.

The findings of this study indicate that the largest contribution to direct medical costs comes from joint prostheses. Given the increasing age of the population and the high prevalence of skeletal diseases such as osteoarthritis, which necessitate knee joint replacement surgery, the costs associated with treatment and joint replacement surgery can impose a significant economic burden on society, the healthcare system, patients, and the country's insurance structure. It is suggested that mechanisms for insurance coverage and government subsidies for joint prostheses be established.