Socioeconomic aspects of total hip arthroplasty. A one-year survey in a Belgian university hospital

Abstract

We prospectively analysed hospital stay, discharge policy, hospital cost and postoperative recovery of 102 consecutive total hip arthroplasties performed in a Belgian university hospital during a one-year period starting in October 2001. Of the independent patients, 87.4% regained independence after 6 weeks and 19.6% used rehabilitation units. Preoperative residence, hip function and mental scores were the best predictors for postoperative independence. Average hospital stay was 14.4 days and hospital cost 9,500 Euros. Hospitalisation represented over 50% of hospital cost and hip implants between 16.1 and 25.6% depending on prosthesis type. Complications and discharge to a rehabilitation unit increased hospital stay and cost. Six months after surgery, functional hip scores as well as WOMAC, mental and physical SF-12 scores improved significantly. Surgical techniques and faster rehabilitation programs, reducing needs for rehabilitation units and allowing earlier return to independence, are probably the best ways to control the cost of total hip arthroplasty in Belgium.