Cost analysis of primary total hip- and knee arthroplasty as a basis for acost effectiveness balance

Introduction: The diagnosis-related reimbursement for total hip- and knee a rthroplasty is often interpreted as a claim for cost reduction and thus inf luences increasingly the surgeon's choice of treatment. With regard to furt her planned budget reductions the following questions arise: Remains qualit y payable? Where are cost savings possible? Patients and methods: Prospective analysis of 21 patients with primary hip- and 26 with knee arthroplasties to identify all cost factors during the ho spitalization period including the implantation technique and quality impro vement measures. Results: Expenses of 18 763.26 DM for hip- and 18 649.40 DM for knee implan ts were covered by the diagnosis-related reimbursement. Compared to cemente d implants, the average total costs of cementless prostheses were usually l ess expensive. Conclusion: Although the current costs are covered, a further reduction of the diagnosis-related reimbursement may result in a loss of quality. The pr esent cost analysis outlines a guideline for an individual calculation and assessment of possible saving effects.