Cost Analysis in Knee Revision Arthroplasty: A Study at the Research and Training Hospital in Turkey

Abstract

This study aimed to investigate the costs covered by the hospital during inpatient treatment of patients who underwent knee revision arthroplasty in the orthopedics and traumatology clinics of a public hospital and compare with the invoiced amount. Methods: The demographic information and revision reasons of 50 patients who underwent total knee revision arthroplasty in a public hospital between 01.01.2016 and 30.09.2017 were determined using hospital information management system records. The patients were categorized into two groups: septic and aseptic. For each patient, the costs of medical consumables, medicine/serum, medical treatment, surgery, anesthesia, imaging services, laboratory procedures, blood and blood products, meal and companion costs, device depreciation expenses, consultation, control examination, preoperative patient preparation stage, surgery, visit and other costs were calculated separately during inpatient treatment. Results: The average total cost of a patient was 24,005.00 TL, whereas the average invoice amount was 21,490.00 TL, with a difference of 2,515.00 TL. This difference was 3,193.00 TL and 2,166.00 TL in the septic and aseptic groups, respectively. In the septic group, the duration of hospital stay, medication, treatment, surgery, anesthesia, laboratory, imaging, blood center, consultation, visit, meal cost, total cost, and invoice amount were significantly higher than the aseptic group (p˂0.05). Conclusion: Regulations by the social security institution are needed to ensure the fiscal sustainability of the public hospital's. In addition, following the medical and technical innovations in revision surgery can help reduce the costs.

The economic impact of two-stage knee arthroplasty revisions: a projection for a specialized health center in Türkiye

“…It has been observed in the literature that when it comes to septic-based revision surgery, the cost of blood products and drugs is significantly higher during inpatient treatment [21]. A cost analysis of septic total knee revision surgeries should include all costs covered by the hospital, including two separate hospitalizations for the two-stage revision and personnel costs [22].…”