title: A population-based study of prevalence and hospital charges in total hip and knee replacement.
abstract: The purpose of this study was to explore the increasing prevalence of factors affecting hospital charges for primary total hip replacement/total knee replacement (THR/TKR). This study analysed 37,918 THR and 76,727 TKR procedures performed in Taiwan from 1996 to 2004. Odds ratio (OR) and effect size (ES) were calculated to assess the relative change rate. Multiple regression models were employed to predict hospital charges. The following factors were associated with increased hospital charges: age younger than 65 years old; increased disease severity (Charlson comorbidity index [CCI] = 1 or > or = 2); absence of primary diagnoses of osteoarthritis (OA), rheumatoid arthritis (RA), avascular necrosis (AVN); treatment at a hospital or by a surgeon performing a high volume of operations; and longer average length of stay (ALOS). The Bureau of National Health Insurance (BNHI) should ensure that surgeons take precautionary measures to minimise complications and maximise quality of life after surgery. Use of joint prostheses from different manufacturers can reduce costs without compromising patient satisfaction.
authors.affiliation: Graduate Institute of Healthcare Administration, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung, 807, Taiwan.
authors.forename: Wei-Che
authors.initials: WC
authors.lastname: Tien
authors.forename: Hao-Yun
authors.initials: HY
authors.lastname: Kao
authors.forename: Yuan-Kun
authors.initials: YK
authors.lastname: Tu
authors.forename: Herng-Chia
authors.initials: HC
authors.lastname: Chiu
authors.forename: King-Teh
authors.initials: KT
authors.lastname: Lee
authors.forename: Hon-Yi
authors.initials: HY
authors.lastname: Shi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000191:economics* / Q000706:statistics & numerical data*; D019645:Arthroplasty, Replacement, Knee / Q000191:economics* / Q000706:statistics & numerical data*; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000175:diagnosis / Q000191:economics / Q000601:surgery; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000191:economics / Q000601:surgery; D010020:Osteonecrosis / Q000175:diagnosis / Q000191:economics / Q000601:surgery; D015995:Prevalence; D012044:Regression Analysis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013624:Taiwan