Changes in surgical loads and economic burden of hip and knee replacements in the US: 1997-2004
Changes in surgical loads and economic burden of hip and knee replacements in the US: 1997-2004
复制标题
DOI：
10.1002/art.23525
复制
发表时间：
2008-04-15
期刊：
影响因子：
--
通讯作者：
Kim, Sunny
中科院分区：
文献类型：
--
作者：
Kim, Sunny
Objective.与关节炎治疗相关的经济负担的一个主要组成部分与髋关节/膝关节的手术关节置换有关。本研究的目的是描述髋关节/膝关节置换术的最新趋势和相关的经济负担。对1997 ~ 2004年全国住院病人调查资料进行分析。采用国际疾病分类第九修订版临床修改程序编码识别关节置换病例。2004年期间，进行了225，900例（95%置信区间[95% CI] 201，782 - 250，018）初次髋关节置换术和431，485例（95% CI 397，454 - 465，516）初次膝关节置换术。与2000年相比，初次髋关节置换增加了37%，初次膝关节置换增加了53%。男性和女性的初次置换手术数量增加相等;但是，45-64岁人群的手术数量过度增加。虽然医疗保险仍然是主要的支付来源（初次髋关节置换术为55.4%，初次膝关节置换术为59.3%），但私人保险支付的增长幅度更大。2004年，全国髋关节/膝关节置换的医院费用为260亿美元，医院成本为91亿美元，报销金额为72亿美元（占医院费用的28%或79%）。到2015年，将有近60万例髋关节置换术和140万例膝关节置换术。关节置换手术的数量比以往任何时候都增长得更快。卫生保健界应考虑和准备这一即将到来的需求的手术负荷及其相关的经济负担。
Objective. A major component of the economic burden associated with the treatment of arthritis relates to surgical joint replacements of the hips/knees. The purpose of this study was to describe the recent trend of hip/knee replacements and the associated economic burden.Methods. The Nationwide Inpatient Survey from 1997 to 2004 was analyzed. The International Classification of Diseases, Ninth Revision, Clinical Modification procedure coding was used to identify joint replacement cases.Results. During 2004, similar to 225,900 (95% confidence interval [95% CI] 201,782-250,018) primary hip replacements and 431,485 (95% CI 397,454-465,516) primary knee replacements were performed. This was a 37% increase in primary hip replacements and a 53% increase in primary knee replacements compared with 2000. The number of primary replacement procedures increased equally for males and females; however, the number of procedures increased excessively among persons age 45-64 years. While Medicare remained the major source of payment (55.4% for primary hip replacements, 59.3% for primary knee replacements), private insurance payment experienced a steeper increase. In 2004, the national bill of hospital charges for hip/knee replacements was $26.0 billion, the hospital cost was $9.1 billion, and the amount of reimbursement was $7.2 billion (28% of hospital charges or 79% of hospital cost). Nearly 600,000 hip replacements and 1.4 million knee replacements will be performed in the year 2015.Conclusion. The number of joint replacement procedures performed is growing faster than ever. The health care community should consider and prepare for this upcoming demand of surgical loads and its associated economical burden.