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Journal of Bone and Joint Infection An open-access journal of the European Bone and Joint Infection Society and the MusculoSkeletal Infection Society
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Volume 3, issue 4
J. Bone Joint Infect., 3, 197–202, 2018
https://doi.org/10.7150/jbji.28508
© Author(s) 2018. This work is distributed under
the Creative Commons Attribution 4.0 License.
J. Bone Joint Infect., 3, 197–202, 2018
https://doi.org/10.7150/jbji.28508
© Author(s) 2018. This work is distributed under
the Creative Commons Attribution 4.0 License.

Original full-length article 08 Sep 2018

Original full-length article | 08 Sep 2018

Economic Impact of Prosthetic Joint Infection - an Evaluation Within the Portuguese National Health System

Arnaldo Sousa1, André Carvalho1, Cláudia Pereira2, Ernestina Reis2, Ana Cláudia Santos3, Miguel Abreu4, Daniel Soares1, Ricardo Fragoso5, Susana Ferreira6, Marcio Reis7, and Ricardo Sousa1 Arnaldo Sousa et al.
  • 1Department of Orthopedics, Centro Hospitalar do Porto, Porto, Portugal
  • 2Department of Internal Medicine, Centro Hospitalar do Porto, Porto, Portugal
  • 3Department of Microbiology, Centro Hospitalar do Porto - Hospital de Santo António, Porto, Portugal
  • 4Department of Infectious Diseases, Centro Hospitalar do Porto, Porto, Portugal
  • 5Department of Information Systems, Centro Hospitalar do Porto, Porto, Portugal
  • 6Department of Information Management, Centro Hospitalar do Porto, Porto, Portugal
  • 7Orthopedics Department Manager, Centro Hospitalar do Porto, Porto, Portugal

Keywords: prosthetic joint infection, Portugese National Health System

Abstract. Introduction: Prosthetic infection is a devastating complication of arthroplasty and carries significant economic burden. The objective of this study was to analyze the economic impact of prosthetic hip and knee infection in Portuguese National Health System.

Material and Methods: Case-control study carried out from January 2014 to December 2015. The mean costs of primary arthroplasties and prosthetic revision surgeries for non-infectious reasons were compared with the costs of prosthetic infections treated with debridement and preservation of the prosthesis or with two-stage exchange arthroplasty.The reimbursement for these cases was also evaluated and compared with its real costs.

Results:A total of 715 primary arthroplasties, 35 aseptic revisions, 16 surgical debridements and 15 revisions for infectious reasons were evaluated. The cost of primary arthroplasties was 3,230€ in the hips and 3,618€ in the knees. The cost of aseptic revision was 6,089€ in the hips and 7,985€ in the knees. In the cases treated with debridement and implant retention the cost was 5,528€ in the hips and 4,009€ in the knees. In cases of infections treated with a two-stage revision the cost was 11,415€ and 13,793€ for hips and knees, respectively.

Conclusion: As far as we know this is the first study that analyzes the economic impact of prosthetic infection in the Portuguese context. Although direct compensation for treating infected cases is much lower than calculated costs, infected cases push the overall hospital case-mix-index upwards thus increasing financial compensation for the entire cohort of treated patients. This knowledge will allow for more informed decisions about health policies in the future.

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