title: The economics of preventing revisions in total hip replacement.
abstract: We showed that the selection of a cost-effective type of cement and method of prophylaxis against deep infections for patients undergoing total hip replacement depended on the number of arthroplasties performed each year at individual hospitals. When 100 arthroplasties were performed each year, the use of Palacos cement and systemic antibiotics reduced the total costs to the department, i.e., the cost of cement, infection prophylaxis and revisions. The use of gentamicin-impregnated cement in combination with systemic antibiotics will further reduce the risk of revision and is another cost-effective strategy. The most effective infection prophylaxis would be achieved with a combination of gentamicin-impregnated cement, systemic antibiotics and surgical enclosure. However, the additional cost of the surgical enclosure would not be offset by cost savings due to reduced risk of revisions.
authors.affiliation: Swedish Institute for Health Economics, Lund, Sweden.
authors.forename: U
authors.initials: U
authors.lastname: Persson
authors.forename: M
authors.initials: M
authors.lastname: Persson
authors.forename: H
authors.initials: H
authors.lastname: Malchau
mesh_terms: D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000191:economics* / Q000706:statistics & numerical data; D001843:Bone Cements / Q000191:economics / Q000627:therapeutic use; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000191:economics* / Q000379:methods*; D018579:Patient Selection; D011475:Prosthesis Failure / Q000191:economics*; D012086:Reoperation / Q000191:economics*; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000191:economics* / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D013548:Sweden / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements