Cost of investigations during the acute hospital stay following total hip or knee arthroplasty, by complication status
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(2020) 20:1036
RESEARCH ARTICLE
Open Access
Cost of investigations during the acute hospital stay following total hip or knee arthroplasty, by complication status Emma Cheng1* , Adriane Lewin1,2,3, Tim Churches1,2,3, Ian A Harris1,2,3 and Justine Naylor1,2,3
Abstract Background: Total hip and total knee arthroplasties are among the most common types of surgery performed in Australia today and are effective treatments for severe osteoarthritis. However, the increasing financial burden on the health system owing to the increasing rates of surgery has led to a growing interest in improving the costeffectiveness and safety of arthroplasty care. This study was designed to quantify the association between postoperative complications, a major cost driver, and the cost of investigations following total hip or knee arthroplasty. Methods: This is a prospective cohort study of consecutive patients undergoing primary total hip or knee arthroplasty at an Australian public hospital. We measured the number and cost of imaging and pathology tests performed during the acute hospital stay and used linear regression to quantify the association between complication status and investigation costs. Results: Five hundred patients were included in the analysis. On average, those with complications received more tests, and more expensive tests. The mean combined cost of imaging and pathology tests in patients with no complications was AU$ 187 (SD: 12.0). In comparison, patients with minor complications had a mean additional cost of AU$ 270 (SD: 31.0), and those with major complications had a mean additional cost of AU$ 493 (SD: 54.2) (p < 0.001). Conclusions: In patients undergoing hip or knee arthroplasty, investigation costs are substantially greater in the presence of either minor or major complications. With growing volumes of total hip and total knee arthroplasties, a potential focus of future research could include optimising investigation practices for patients with and without complications. Keywords: Total hip arthroplasty, Total knee arthroplasty, Cost, Investigations, Imaging, Pathology, Complications, Postoperative complications
Background Total hip and total knee arthroplasty (THA/TKA) are among the most common types of surgeries performed in Australia, where over 100,000 arthroplasties are performed every year, mostly for the treatment of severe osteoarthritis [1]. The current cost of THA/TKA is AU$ * Correspondence: [email protected] 1 South Western Sydney Clinical School, South West Sydney Clinical School UNSW, Liverpool Hospital, Locked Bag 7103, Liverpool BC, NSW 1871, Australia Full list of author information is available at the end of the article
2 billion annually, though with an ageing population and increasing rate of obesity, the annual cost is projected to reach AU$ 5.32 billion by 2030 [2]. The increasing financial burden of arthroplasty on the health system has led to a growing interest in improving the cost efficiency and safety of these surgeries. While there has been much research on many aspects o
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