Direct Inpatient Medical Costs of Operative Treatment of Periprosthetic Hip and Knee Infections Are Twofold Higher Than Those of Aseptic Revisions
| Autor: | Jeanine E. Ransom, Jie J. Yao, David G. Lewallen, Sue L. Visscher, Daniel J. Berry, Mario Hevesi, Hilal Maradit Kremers |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Reoperation musculoskeletal diseases medicine.medical_specialty Prosthesis-Related Infections Arthroplasty Replacement Hip Total knee arthroplasty Periprosthetic Tertiary care Article 03 medical and health sciences 0302 clinical medicine medicine Humans Orthopedics and Sports Medicine 030212 general & internal medicine Arthroplasty Replacement Knee Therapeutic Irrigation health care economics and organizations Reimbursement Aged Retrospective Studies Aged 80 and over 030222 orthopedics business.industry Incidence (epidemiology) Level iv Health Care Costs General Medicine Middle Aged Surgery Debridement Female Aseptic processing business Medical costs |
| Zdroj: | J Bone Joint Surg Am |
| ISSN: | 1535-1386 0021-9355 |
| Popis: | BACKGROUND Periprosthetic joint infections (PJIs) following total hip arthroplasty (THA) and total knee arthroplasty (TKA) are associated with substantial morbidity. A better understanding of the costs of PJI treatment can inform prevention, treatment, and reimbursement strategies. The purpose of the present study was to describe direct inpatient medical costs associated with the treatment of hip and knee PJI. METHODS At a single tertiary care institution, 176 hips and 266 knees that underwent 2-stage revisions for the treatment of PJI from 2009 to 2015 were compared with 1,611 hips and 1,276 knees that underwent revisions for aseptic indications. In addition, 84 hips and 137 knees that underwent irrigation and debridement (I&D) with partial component exchange were compared with 39 hips and 138 knees that underwent partial component exchange for aseptic indications. Line-item details of services billed during hospitalization were retrieved, and standardized direct medical costs were calculated in 2018 inflation-adjusted dollars. RESULTS The mean direct medical cost of 2-stage revision THA performed for the treatment of PJI was significantly higher than that of aseptic revision THA ($58,369 compared with $22,846, p < 0.001). Similarly, the cost of 2-stage revision TKA performed for the treatment of PJI was significantly higher than that of aseptic revision TKA ($56,900 compared with $24,630, p < 0.001). Even when the total costs of aseptic revisions were doubled for a representative comparison with 2-stage procedures, the costs of PJI procedures were 15% to 28% higher than those of the doubled costs of aseptic revisions (p < 0.001). The mean direct medical cost of I&D procedures for PJI was about twofold higher than of partial component exchange for aseptic indications. CONCLUSIONS The direct medical costs of operative treatment of PJI following THA and TKA are twofold higher than the costs of similar aseptic revisions. The high economic burden of PJI warrants efforts to reduce the incidence of PJI. Reimbursement schemes should account for the high costs of treating PJI in order to ensure sustainable patient care. LEVEL OF EVIDENCE Economic Level IV. See Instructions for Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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