Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China.
Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, Hunan 410008, China.
Chin Med J (Engl). 2023 Sep 5;136(17):2050-2057. doi: 10.1097/CM9.0000000000002220.
There are limited data on the resource utilization of total knee arthroplasty (TKA) in China. This study aimed to examine the length of stay (LOS) and inpatient charges of TKA in China, and to investigate their determinants.
We included patients undergoing primary TKA in the Hospital Quality Monitoring System in China between 2013 and 2019. LOS and inpatient charges were obtained, and their associated factors were further assessed using multivariable linear regression.
A total of 184,363 TKAs were included. The LOS decreased from 10.8 days in 2013 to 9.3 days in 2019. The admission-to-surgery interval decreased from 4.6 to 4.2 days. The mean inpatient charges were 61,208.3 Chinese Yuan. Inpatient charges reached a peak in 2016, after which a gradual decrease was observed. Implant and material charges accounted for a dominating percentage, but they exhibited a downward trend, whereas labor-related charges gradually increased. Single marital status, non-osteoarthritis indication, and comorbidity were associated with longer LOS and higher inpatient charges. Female sex and younger age were associated with higher inpatient charges. There were apparent varieties of LOS and inpatient charges among provincial or non-provincial hospitals, hospitals with various TKA volume, or in different geographic regions.
The LOS following TKA in China appeared to be long, but it was shortened during the time period of 2013 to 2019. The inpatient charges dominated by implant and material charges exhibited a downward trend. However, there were apparent sociodemographic and hospital-related discrepancies of resource utilization. The observed statistics can lead to more efficient resource utilization of TKA in China.
中国关于全膝关节置换术（TKA）资源利用的数据有限。本研究旨在探讨中国 TKA 的住院时间（LOS）和住院费用，并探讨其决定因素。
我们纳入了 2013 年至 2019 年期间在中国医院质量监测系统中接受初次 TKA 的患者。获取 LOS 和住院费用，并使用多变量线性回归进一步评估其相关因素。
共纳入 184363 例 TKA。LOS 从 2013 年的 10.8 天减少到 2019 年的 9.3 天。入院至手术间隔从 4.6 天减少到 4.2 天。平均住院费用为 61208.3 元人民币。住院费用在 2016 年达到峰值，之后呈逐渐下降趋势。植入物和材料费用占主导地位，但呈下降趋势，而与劳动力相关的费用逐渐增加。单身状态、非骨关节炎适应证和合并症与 LOS 延长和住院费用增加有关。女性和年轻患者与较高的住院费用有关。在省级和非省级医院、TKA 量不同的医院或不同地理区域之间，LOS 和住院费用存在明显差异。
中国 TKA 后的 LOS 似乎较长，但在 2013 年至 2019 年期间缩短。以植入物和材料费用为主的住院费用呈下降趋势。然而，存在明显的社会人口学和医院相关资源利用差异。观察到的统计数据可以使中国 TKA 的资源利用更加高效。
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