[An estimate of the intramural costs of the placement of a total hip prosthesis].

OBJECTIVE

Determining the intramural costs of the (re) placement of a total hip prostheses.

DESIGN

Retrospective, descriptive.

SETTING

Utrecht University Hospital (AZU) and the De Weezenlanden Hospital in Zwolle (ZWZ), the Netherlands.

PATIENTS AND METHOD

From the records of 137 patients in whom an uncomplicated primary placement or revision of 151 total hip prostheses had taken place in the AZU or the ZWZ during the period 1990-93, data were collected on the number of days hospitalised, the length of the operation, the medical materials used, the number of radiological procedures, ECG's and laboratory determinations, and the visits to the outpatient clinic. The costs of a hip replacement were determined on the basis of the salary costs, tariffs and purchase prices.

RESULTS

The average total cost was f 9381 for the placement of a cemented prosthesis, f 10,796 for the placement of a cement-free prosthesis, and f 17,879 for a revision operation. About 90% of the total costs were due to the price of hospitalization, surgery and prosthesis. With 14,000 primary placements and 1400 revisions annually, the cost is approximately 186 million guilders. An expected increase in the number of hip replacements and their cost should be taken into consideration.