title: [Sledge versus bicondylar surface treatment in the endoprosthetic therapy for unicompartmental knee arthrtitis--a comparative cost analysis].
abstract: BACKGROUND
  The G-DRG system reimburses sledge endoprosthetic implantations (UKA) at a much lower rate than surface replacements (TKA), at significantly different cost weights (CW). Therefore, when only G-DRG payments are considered, the complete endoprosthesis implantation produces higher gains. An orientation on these revenues alone, however, does not provide the basis for an economically sound decision-making process. The aim of this study is to present a comparison of the variable costs of the two procedures.
  
  
  METHODS
  The mean cost and performance data of 28 Endo-Model UKA implantations and of 85 NexGen CR TKA replacements were compared with each other in 2007.
  
  
  RESULTS
  From the perspective of the hospital, when the correct medical indication is present, UKA treatment is of greater economic advantage. In this way the total unit contribution margin can be improved, and although the relative weighting is comparatively low, the costs are significantly lower than in a comparative analysis of the TKA.
  
  
  CONCLUSIONS
  For the desired maximisation of the unit contribution margin, assuming that it is the proper medical indication, the recommendation for the hospital would be implantation of the UKA. Considered from the economic perspective of gains and costs, the assumption that a TKA would be advantageous could not be confirmed in the present study.
authors.affiliation: Klinik und Poliklinik für Orthopädie und Orthopädische Chirurgie, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, Klinikumsneubau, Greifswald. richard.kasch@uni-greifswald.de
authors.forename: R
authors.initials: R
authors.lastname: Kasch
authors.forename: S
authors.initials: S
authors.lastname: Merk
authors.forename: R
authors.initials: R
authors.lastname: Kayser
authors.forename: A
authors.initials: A
authors.lastname: Lahm
authors.forename: W
authors.initials: W
authors.lastname: Drescher
authors.forename: A P
authors.initials: AP
authors.lastname: Schulz
authors.forename: T
authors.initials: T
authors.lastname: Wilke
authors.forename: S
authors.initials: S
authors.lastname: Flessa
mesh_terms: D000368:Aged; D005260:Female; D005858:Germany; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007720:Knee Prosthesis / Q000191:economics*; D008297:Male; D020370:Osteoarthritis, Knee / Q000191:economics* / Q000601:surgery*; D016896:Treatment Outcome