[Cost analysis of hip and knee prostheses as the basis for cost-benefit evaluation].
BACKGROUND
The diagnosis-related reimbursement for total hip- and knee arthroplasty is often interpreted as a claim for cost reduction and thus influences increasingly the surgeon's choice of treatment. With regard to further planned budget reductions the following questions arise: Remains quality payable? Where are cost savings possible?


METHODS
Prospective analysis of 21 patients with primary hip- and 26 with knee arthroplasties to identify all cost factors during the hospitalization period including the implantation technique and quality improvement measures.


RESULTS
Expenses of 18,763.26 DM for hip- and 18,649.40 DM for knee implants were covered by the diagnosis-related reimbursement. Compared to cemented implants, the average total costs of cementless prostheses were usually less expensive.


CONCLUSIONS
Although the current costs are covered, a further reduction of the diagnosis-related reimbursement may result in a loss of quality. The present cost analysis outlines a guideline for an individual calculation and assessment of possible saving effects.
Orthopädische Universitäts- und Poliklinik Essen.
R T
RT
Müller
N
N
Schürmann
D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000191:economics*; D019645:Arthroplasty, Replacement, Knee / Q000191:economics*; D002017:Budgets; D003362:Cost-Benefit Analysis; D005260:Female; D005858:Germany; D017721:Hospital Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics*; D011474:Prosthesis Design / Q000191:economics