Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2015 Jan;56(1):58-64.
doi: 10.11622/smedj.2015011.

Comparison of total hip and knee joint replacement in patients with rheumatoid arthritis and osteoarthritis: a nationwide, population-based study

Chi-Yang Liao, Hui-Ting Chan, En Chao, Che-Ming Yang, Tzu-Chuan Lu  1
Affiliations
Comparative Study

Comparison of total hip and knee joint replacement in patients with rheumatoid arthritis and osteoarthritis: a nationwide, population-based study

Chi-Yang Liao et al. Singapore Med J. 2015 Jan.

Abstract

Introduction: Patients with rheumatoid arthritis (RA) and osteoarthritis (OA) may require total hip replacement (THR) or total knee replacement (TKR). The present study aimed to compare the demographic characteristics and medical costs of RA and OA patients from Taiwan who underwent either THR or TKR.

Methods: The medical records of patients who had undergone THR or TKR from 1 January 1996 to 31 December 2010 were obtained from the Taiwan National Health Insurance Research Database (NHIRD). In all, we found 49 and 146 RA patients who received THR and TKR, respectively, and 1,191 and 6,574 OA patients who received THR and TKR, respectively. The gender, age, Charlson comorbidity index (CCI), hospital grade, age at registration in the catastrophic illness dataset, and medical utilisation costs of the different groups were compared.

Results: There were statistically significant differences in age, CCI score, drug costs and surgery costs between RA and OA patients. Joint replacement incidence was lower in RA patients than in OA patients, and among patients who underwent THR, total medical costs incurred were higher for RA patients than OA patients. RA patients who underwent THR incurred a significantly greater total medical utilisation cost in the outpatient department (3 months before surgery and 12 months after surgery) than OA patients who underwent THR.

Conclusion: Analysis of Taiwan NHIRD with regard to patients who had undergone either THR or TKR indicated that RA patients were younger than OA patients, and that significantly more medical resources were used for RA patients before, during and after hospitalisation for these procedures.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Flowchart shows the identification process of rheumatoid arthritis (RA) and osteoarthritis (OA) patients for the present study from a pool of 1,000,000 patients (data extracted from 1 January 1996 to 31 December 2010) who underwent either total hip replacement (THR) or total knee replacement (TKR). *Identified by ICM-9-CM diagnosis codes 715.00–715.98. †Identified by ICM-9-CM diagnosis code 714.0. NHIRD: National Health Insurance Research Database; LHID: Longitudinal Health Insurance Database
See this image and copyright information in PMC

Comment in

References

    1. Chang RW, Pellisier JM, Hazen GB. A cost-effectiveness analysis of total hip arthroplasty for osteoarthritis of the hip. JAMA. 1996;275:858–65. - PubMed
    1. Lajas C, Abasolo L, Bellajdel B, et al. Costs and predictors of costs in rheumatoid arthritis: a prevalence-based study. Arthritis Rheum. 2003;49:64–70. - PubMed
    1. Gibofsky A. Epidemiology, pathophysiology, and diagnosis of rheumatoid arthritis: A Synopsis. Am J Manag Care. 2014;20(7 Suppl):S128–45. - PubMed
    1. Silman AJ, MacGregor AJ, Thomson W, et al. Twin concordance rates for rheumatoid arthritis: results from a nationwide study. Br J Rheumatol. 1993;32:903–7. - PubMed
    1. Bellamy N, Duffy D, Martin N, Mathews J. Rheumatoid arthritis in twins: A study of aetiopathogenesis based on the Australian Twin Registry. Ann Rheum Dis. 1992;51:588–93. - PMC - PubMed

Publication types