Scheerlinck Thierry, Duquet William, Casteleyn Pierre-Paul
Vrije Universiteit Brussel, Department of Orthopaedic Surgery and Trauma, Brussels, Belgium.
Acta Orthop Belg. 2004 Dec;70(6):525-33.
We prospectively analysed hospital stay, discharge policy, hospital cost and postoperative recovery of 102 consecutive total hip arthroplasties performed in a Belgian university hospital during a one-year period starting in October 2001. Of the independent patients, 87.4% regained independence after 6 weeks and 19.6% used rehabilitation units. Preoperative residence, hip function and mental scores were the best predictors for postoperative independence. Average hospital stay was 14.4 days and hospital cost 9,500 Euros. Hospitalisation represented over 50% of hospital cost and hip implants between 16.1 and 25.6% depending on prosthesis type. Complications and discharge to a rehabilitation unit increased hospital stay and cost. Six months after surgery, functional hip scores as well as WOMAC, mental and physical SF-12 scores improved significantly. Surgical techniques and faster rehabilitation programs, reducing needs for rehabilitation units and allowing earlier return to independence, are probably the best ways to control the cost of total hip arthroplasty in Belgium.
我们前瞻性地分析了2001年10月起的一年时间里,在比利时一家大学医院连续进行的102例全髋关节置换术的住院时间、出院政策、住院费用和术后恢复情况。在独立患者中,87.4%在6周后恢复独立,19.6%使用了康复单元。术前居住情况、髋关节功能和心理评分是术后独立的最佳预测指标。平均住院时间为14.4天,住院费用为9500欧元。住院费用占总费用的50%以上,髋关节植入物费用占16.1%至25.6%,具体取决于假体类型。并发症和转至康复单元会增加住院时间和费用。术后6个月,髋关节功能评分以及WOMAC、心理和身体SF-12评分均显著改善。手术技术和更快的康复方案,减少对康复单元的需求并使患者更早恢复独立,可能是控制比利时全髋关节置换术费用的最佳方法。