title: [Hybrid and uncemented hip arthroplasty: Contribution margin in the German lump sum reimbursement system].
abstract: BACKGROUND
  The economization of inpatient care began when lump sum reimbursement was introduced into the hospital sector. Since then, total hip arthroplasty (THA) has experienced a rapid development in terms of annual procedures and the optimization of the clinical pathway. Therefore, it is obvious to highlight THA as one of the most common procedures in the German health care system. In this work, the two most common techniques for the fixation of THA are investigated with regard to their cost structure and their influence on the clinical result.
  
  
  OBJECTIVE
  In Germany, uncemented and hybrid fixation are used for THA. In this study we investigated the differences in material costs, the duration of surgery, and the length of stay.
  
  
  METHODS
  For each fixation technique a retrospective cost analysis was carried out, based on the data from the treatment documentation of the University Hospital for Orthopedics, Rostock (OUK). The mean values of the parameters and expenses have been reviewed with descriptive statistics for differences.
  
  
  RESULTS
  With regard to total costs and the contribution margin there was no statistically significant difference.
  
  
  CONCLUSIONS
  Although there are differences in individual cost areas, in total costs, cost advantages and disadvantages cancel each other out. Thus, from an economic perspective no particular technique can be recommended.
authors.affiliation: Hochschule Ludwigshafen am Rhein, Ernst-Boehe-Str. 4, 67059, Ludwigshafen am Rhein, Deutschland, tim.hanstein@gmail.com.
authors.forename: Tim
authors.initials: T
authors.lastname: Hanstein
authors.forename: O
authors.initials: O
authors.lastname: Kumpe
authors.forename: W
authors.initials: W
authors.lastname: Mittelmeier
authors.forename: R
authors.initials: R
authors.lastname: Skripitz
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000191:economics* / Q000379:methods*; D002484:Cementation / Q000191:economics* / Q000379:methods*; D003365:Costs and Cost Analysis; D003953:Diagnosis-Related Groups / Q000191:economics; D005260:Female; D005858:Germany; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage / Q000191:economics*; D007902:Length of Stay / Q000191:economics; D008297:Male; D009313:National Health Programs / Q000191:economics*; D015207:Osteoarthritis, Hip / Q000191:economics* / Q000601:surgery*; D012051:Reimbursement Mechanisms / Q000191:economics*; D012189:Retrospective Studies