Comparison of Direct Hospitalization Costs during Staged Versus Simultaneous Total Knee Arthroplasty: Thailand National Health Security Program
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Abstract
Background: As Thai lifespans lengthen, so there is an increase in patients diagnosed with osteoarthritis (OA) of the knee. Total knee arthroplasty (TKA) has been widely proved to improve quality of life. A comparison of overall costs between staged and simultaneous bilateral TKA can help the public health budget. There are few studies comparing the overall cost of staged and simultaneous bilateral TKA in Thailand.
Methods: The patient database was searched for those with ICD10 code 87.54 from 1 January 2014 to 31 December 2014 , totaling 176 patients. Total medical costs of 64 patients were included in the study; 49 patients who received staged bilateral TKA were compared with 15 patients who received simultaneous bilateral TKA.
Results: Most categories of medical costs were significantly lower in the simultaneous TKA group. (mean total cost was 54,524 baht in simultaneous bilateral TKA and 63,115 baht in staged TKA; p value = 0.0118)
Conclusions: Simultaneous bilateral TKA is more cost effective than staged TKA in Thailand’s national health security program.
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References
2. Mclnnis DP, Devane PA, Horne G. Bilateral total knee arthroplasty: Indications and complications. Curr Cpin Orthop. 2003;14: 52-7.
3. Restrepo C, Parvizi J, Dietrich T, Einhorn TA. Safety of simultaneous bilateral total knee arthroplasty. A meta-analysis. J Bone Joint Surg Am. 2007;89(6):1220-6.
4. Lin AC, Chao E, Yang CM, Wen HC, Ma HL, Lu TC. Costs of staged versus simultaneous bilateral total knee arthroplasty: a population-based study of the Taiwanese National Health Insurance Database. J Orthop Surg Res. 2014;15;9:59.
5. Reuben JD, Meyers SJ, Cox DD, Elliott M, Watson M, Shim SD. Cost comparison between bilateral simultaneous, staged, and unilateral total joint arthroplasty. J Arthroplasty. 1998,13:172-9.
6. Stubbs G, Pryke SE, Tewari S, Rogers J, Crowe B, Bridgfoot L, et al. Safety and cost-benefits of bilateral total knee replacement in an acute hospital. ANZ J Surg. 2005;75(9):739-46.
7. Kovacik MW, Singri P, Khanna S, Gradisar IA. Medical and Financial aspects of same-day bilateral total knee arthroplasties. Biomed Sci instrum. 1997;33: 429-34.
8. March LM, Cross M, Tribe KL, Lapsley HM, Courtenay BG, Cross MJ, et al. Two knees or not two knees? Patients costs and outcomes following bilateral and unilateral total knee joint replacement surgery for OA. Osteoarthritis Cartilage. 2004;12(5):400-8.
9. Verathaworn W. Cost of treatment for Total knee arthroplasty in osteoarthritis patient at Ramathibodi Hospital. [Thesis]. Bangkok: Mahidol University; 2004.
10. นัฐวุฒิ วิวรรธนวรางค์. ต้นทุนโดยตรงของการผ่าตัดเปลี่ยนข้อเข่าเทียมในโรงพยาบาลเชียงรายประชานุเคราะห์. เชียงรายเวชสาร. 2554;3(2): 61-7.
11. Raviraj A, Chakravarthy M, Pai A, Prabhu A:Comparison of simultaneous bilateral and staged bilateral total knee arthroplasty in term of perioperative complications. J Arthroplasty. 2011;26: 165-6.
12. Ritter MA, Harty LD, David KE, Meding JB, Berend M. Simultaneous bilateral, staged bilateral, and unilateral total knee arthroplasty .A survival analysis . J Bone Joint Surg Am. 2003;85: 1532-7.
13. Ritter MA, Harty LD. Debate: simultaneous bilateral knee replacements. The outcomes justify its use. Clin Orthop Relat Res. 2004;428: 84-5.
14. Felson DT. The epidemiology of osteoarthritis.Result from the Framingham osteoarthritis study. Semin Arthritis Rheum. 1990;20 (suppl 1):42-50.
15. สำนักงานหลักประกันสุขภาพแห่งชาติ ผู้มีสิทธิหลักประกันสุขภาพของประเทศจำแนกตามกลุ่มสิทธิและสถานะ. [internet]. 2016 [cited 2016 Nov 4].Available from: http://eisnhso.go.th/FrontEnd/Novenber 27.2011.