[Primary hip- and knee arthroplasty--comparison of the actual costs with the Australian diagnosis related groups (DRG)-].
OBJECTIVE
With the introduction of the Australian DRG system in Germany the question arises which current procedures remain reasonable in cost. The present study compares the actual costs with the expected DRG reimbursement.


METHODS
Prospective analysis of 23 patients with primary hip and 26 with knee arthroplasty was performed to identify all cost factors during the hospitalization period including all applied measures. Retrospective analysis was carried out of the additional costs of relevant concomitant diseases (liver transplantation, haemophilia).


RESULTS
Expenses of 6231 euro; for hip and 6453 euro; for knee implants were covered by the DRG reimbursement. Although a special reimbursement was paid, the additional costs of the concomitant diseases resulted in a financial loss.


CONCLUSIONS
To cover the current costs for patients free of complications, an enormous reduction of the length of stay is required. Otherwise complicated cases may result in a loss of quality or selection of patients. The present cost analysis outlines a guideline for an individual calculation and assessment of the necessary DRG reimbursement.
Schürmann
N
N
Orthopädische Universitäts- und Poliklinik, Essen, Germany.
Müller
R T
RT
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000191:economics*; D019645:Arthroplasty, Replacement, Knee / Q000191:economics*; D015897:Comorbidity; D003365:Costs and Cost Analysis; D003953:Diagnosis-Related Groups / Q000191:economics*; D005260:Female; D005858:Germany; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics*; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics*; D011446:Prospective Studies