Document Detail


Direct Hospital Cost Determinants Following Hip and Knee Arthroplasty.
MedLine Citation:
PMID:  25470687     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective Total joint arthroplasty (TJA) places a significant economic burden on healthcare resources. This cohort study examines the costs associated with arthroplasty in 827 patients undergoing hip and knee TJA from January 2011 to June 2012 at a single centre in Melbourne, Australia. Methods Data included total inpatient, outpatient and readmissions costs in the 30 days following TJA. Factors associated with cost were modelled using negative binomial regression and extrapolated to the Australian population. Results The base cost (i.e. the cost in a patient with no modifying factors) over the first 30 days following TJA was Australian (AU) $13060 (Interquartile range AU$12126, 14067). The median length of stay was 4 days (range 2-33) and 35 patients (4%) were readmitted in the first 30 days following index TJA, the majority of whom had a surgical site infection (SSI) (74%). The following factors were independently associated with increased costs: SSI, pre-operative warfarin therapy, American Society of Anesthesiologists (ASA) score of 3 or 4, hip TJA, increasing operation time, increasing post-operative blood transfusion requirements, other nosocomial infections, post-operative venous thromboembolism (VTE), pressure ulcers, post-operative confusion and acute urinary retention. Based on data from the present study, the cost of TJA in Australia is estimated to exceed AU$1 billion per year. Preventable post-operative complications were major cost drivers: SSI and VTE added a further AU$97 million and AU$66 million, respectively, to arthroplasty costs in the first 30 days following surgery. Conclusions This unique study has identified important factors influencing TJA costs and providing guidance for future research and resource allocation. This article is protected by copyright. All rights reserved.
Authors:
Tn Peel; Ac Cheng; D Liew; Kl Buising; J Lisik; Ka Carroll; Pfm Choong; Mm Dowsey
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-12-2
Journal Detail:
Title:  Arthritis care & research     Volume:  -     ISSN:  2151-4658     ISO Abbreviation:  Arthritis Care Res (Hoboken)     Publication Date:  2014 Dec 
Date Detail:
Created Date:  2014-12-3     Completed Date:  -     Revised Date:  2014-12-4    
Medline Journal Info:
Nlm Unique ID:  101518086     Medline TA:  Arthritis Care Res (Hoboken)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 American College of Rheumatology.
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