1Department of Traumatology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2School of Medicine, University of Split, Split, Croatia; 3School of Dental Medicine, University of Zagreb, Zagreb, Croatia; 4University of Applied Health Sciences, Zagreb, Croatia; 5School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 6Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.
Acta Clin Croat. 2020 Dec;59(4):667-671. doi: 10.20471/acc.2020.59.04.13.
In recent years, there has been increased interest in the cost of treatment for revision interventions for hip and knee prostheses. In all publications so far, the authors note the high cost of treatment for revision interventions, especially if infection is present. The aim of this study was to compare the cost of treatment and health insurance reimbursements between revision total hip arthroplasty (THA) for infection and revision for aseptic indications (aseptic instability and periprosthetic fracture). Hospital data on 168 patients having undergone revision THA between 2010 and 2018 at the Department of Traumatology, Sestre milosrdnice University Hospital Centre from Zagreb were analyzed. Financial data were collected from the Hospital Information System. Financial analysis included total cost patient, Croatian Health Insurance Fund reimbursements, cost of implants, and length of hospital stay. The difference between the mean total cost patient and the mean Croatian Health Insurance Fund reimbursements was -262.83 € (-6.08%) for aseptic instability, -1694.94 € (-17.25%) for infection and -916.49 € (-17.33%) for periprosthetic fracture. The Croatian Health Insurance Fund does not recognize differences in the cost of revision THA for aseptic instability, infection and periprosthetic fracture. Health insurance reimbursement is inadequate for centers that offer revision hip surgery.
近年来，人们对髋关节和膝关节假体翻修干预措施的治疗成本越来越感兴趣。在迄今为止的所有出版物中，作者都注意到翻修干预措施的治疗成本很高，尤其是如果存在感染的情况下。本研究的目的是比较感染性全髋关节翻修术（THA）与无菌性翻修术（无菌性不稳定和假体周围骨折）的治疗成本和健康保险报销情况。对 2010 年至 2018 年期间在萨格勒布的斯特雷米尔罗米奇纳大学医院创伤科接受 THA 翻修的 168 名患者的医院数据进行了分析。财务数据从医院信息系统中收集。财务分析包括患者的总费用、克罗地亚健康保险基金的报销、植入物的成本和住院时间。对于无菌性不稳定，患者的平均总费用与克罗地亚健康保险基金的平均报销费用之间的差异为-262.83 欧元（-6.08%），对于感染，差异为-1694.94 欧元（-17.25%），对于假体周围骨折，差异为-916.49 欧元（-17.33%）。克罗地亚健康保险基金不承认无菌性不稳定、感染和假体周围骨折的 THA 翻修成本差异。对于提供髋关节翻修手术的中心来说，健康保险报销不足。
