Economic Analysis of 4221 Revisions Due to Periprosthetic Joint Infection in Poland
Journal Title: Ortopedia Traumatologia Rehabilitacja - Year 2017, Vol 19, Issue 1
Abstract
[b]Background. [/b]Periprosthetic joint infection (PJI) is one of the most severe complications of total hip (THA) and total knee (TKA) arthroplasty. The aim of the study is to determine the number and type of hip and knee prosthesis revisions in Poland performed due to infection and reimbursement of the cost of septic revisions and to compare the costs of septic and aseptic revisions in Poland and other countries.[b]Material and methods. [/b]The data published for the period 2009-2013 by the National Health Fund (NHF) were analysed and the average cost of septic and aseptic revisions was calculated.[b]Results.[/b] In the years 2009-2013, a total of 260,030 hip and knee arthroplasties including 23,027 revisions (incl. 4,221 septic) were performed in Poland. In 2013, septic revisions accounted for 1.38% of all hip replacement procedures, 2.56% of all knee replacement procedures and 14.67% of all hip revisions and 30.23% of all knee revisions. In 2013, the difference between the average cost incurred by the hospital and the NHF refund for septic revision due to PJI was at least €238 and the cost-refund gap for the entire year was €219198.[b]Conclusion. [/b]1. The system of reporting periprostheticjoint infections currently in use in Poland does not adequately reflect the current classification of PJI and reimbursement for septic revision of joint prosthesis does not match the actual costs. 2. The Polish DRG system does not distinguish between early and late PJI and fails to acknowledge basic guidelines for infection treatment currently followed in Poland and worldwide. 3. According to the DRG system, patients requiring different treatment are placed in one category. 4. Until the year 2013, the less expensive treatment of early infections had been reimbursed on the same basis as the more costly two-stage revision procedures.
Authors and Affiliations
Ireneusz Babiak, Piotr Pędzisz, Jakub Janowicz, Mateusz Kulig, Paweł Małdyk
Miejscowe podawanie preparatów sterydowych.
Naturalne kortykosterydy (KS) są syntetyzowane w korze nadnerczy i włączane w liczne procesy metaboliczne organizmu. Leki sterydowe (steroidowe), dzięki silnym właściwościom przeciwzapalnym i szerokim spektrum działania,...
CELL AND MOLECULAR MECHANISMS OF REGENERATION AND REORGANIZATION OF SKELETAL MUSCLES
The process of skeletal muscle regeneration comprises four phases: degeneration, inflammatory and immune response, regeneration and remodelling, which are regulated by a number of molecules secreted, by muscle cells and...
Histological aspects of bone fracture healing
Bone fracture healing is a multistep phenomenon leading to full restoration of the damaged tissue. It replicates the events that happen during endochondral bone formation in prenatal life. The mechanisms which control bo...
Chondrectomy – Review of Surgical Instrumentation and its Effectiveness
[b]Βackground.[/b] To present surgical instrumentation used in knee chondrectomy and evaluate its effectiveness – a review of the literature. Surgical removal of joint cartilage, or chondrectomy, has been p...
Assesment scores of functional efficiency in hip osteoathritis
One of the fundamental problem to solved, connected with a way of proceeding in hip osteoarthritis is appropriate selection of diagnosis methods. Various scores helps in assessment of functional efficiency of the hip. Th...