PP156 退行性关节病患者在全髋关节置换术中不同植入物组合的选择

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS
YuHan Huang, Ta-Wei Tai, Jung-Der Wang, Li Jung Elizabeth Ku
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引用次数: 0

摘要

在台湾,患有髋关节骨关节炎(OA)的人接受全髋关节置换术(THA)。他们可以申请国民健康保险(NHI)覆盖的金属对聚乙烯(MoP)植入物或$ 1,313.2共同支付新的轴承表面材料。本研究旨在报道首次原发性人工髋关节置换术的数量,并通过选择不同的假体来计算人工髋关节置换术的费用。方法根据台湾国民健康保险索赔数据,对2010年1月1日至2018年12月31日期间50岁及以上OA(作为THA的指征)患者进行回顾性队列研究。该队列随访至2019年12月31日。THA种植体的组合是通过将表面材料如“陶瓷-金属”装入氧化铝或由氧化铝和氧化锆制成的复合材料来定义的,包括金属对聚乙烯(MOP)、陶瓷-金属复合陶瓷对聚乙烯(c-COP)、氧化铝陶瓷对陶瓷(a-COC)、陶瓷-金属复合陶瓷对陶瓷(c-COC)。由于国民健康保险只覆盖MOP,选择COP或COC植入物的患者必须支付额外费用。我们使用医院费用比较数据来计算不同种植体组合的平均自付费用(OOP)。结果该研究纳入了23,560例首次原发性THA患者,随访时间超过9年。首次原发性THA患者从2010年的1802例增加到2018年的3251例。基线时患者的平均年龄为68岁,以女性为主(70.6%)。每种THA种植体的用户比例分别为:MOP种植体(49.2%)、c-COC种植体(20.8%)、a-COC种植体(6.5%)和c-COP种植体(5.9%)。每个种植体的平均OOP成本为:c-COC (SD=381.80) 3,578.60美元,a-COC (SD=279.80) 2,073.00美元,c-COP (SD=334.1) 2,082.1美元。结论虽然只有MOP被NHI完全覆盖,但只有约50%的OA患者选择这种类型的种植体,而26.7%的患者选择氧化铝和氧化锆陶瓷复合材料,尽管这是一个更高的OOP成本。在台湾的医疗系统中,选择更昂贵的植入物是否具有成本效益还需要进一步分析。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
PP156 Choice Of Different Implant Combinations of Total Hip Arthroplasty For Patients With Degenerative Joint Disease
Introduction

In Taiwan, people with hip osteoarthritis (OA) receive a total hip arthroplasty (THA). They can apply for National Health Insurance (NHI) coverage for metal-on-polyethylene (MoP) implant or USD1,313.2 co-pay for new bearing surface materials. This study aimed to report the number of first primary THAs, and calculate the costs of THA by different choices of prothesis implant.

Methods

A retrospective cohort study of patients aged 50 years or older who had OA (as an indication for THA) from 1 January 2010 through to 31 December 2018 was established from Taiwan’s NHI Claims Data. The cohort was followed-up until 31 December 2019. THA Implant combinations were defined by bearing surface materials e.g., “ceramic-metal” into alumina or composites made from alumina and zirconia, including metal-on-polyethylene (MOP), ceramic-metal composite ceramic-on-polyethylene (c-COP), alumina ceramic-on-ceramic (a-COC), ceramic-metal composite ceramic-on-ceramic (c-COC). Since only MOP was covered by the NHI, patients who chose the COP or COC implant had to pay for additional costs. We used hospital costs comparison data to calculate the average out-of-pocket (OOP) costs for different implant combinations.

Results

This study comprised 23,560 patients with first primary THA over 9 years. The number of patients of first primary THA increased from 1,802 in 2010 to 3,251 in 2018. The mean age of patients at baseline was 68 years, and the majority were women (70.6%). The share of users for each THA implant type were: MOP implant (49.2%), c-COC implant, (20.8%), a-COC implant, (6.5%), and c-COP implant, 5.9%. The average OOP costs of each implant were: USD3,578.60 for c-COC (SD=381.80), USD2,073.00 for a-COC (SD=279.80), and USD2,082.1 for c-COP (SD=334.1).

Conclusions

Although only MOP was fully covered by NHI, only about 50% of the OA patients chose this type of implant, and 26.7 percent chose alumina and zirconia ceramic composite despite this being a much higher OOP cost. Whether choosing more expensive implants would be cost-effective for THA in Taiwan’s healthcare system requires further analysis.

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来源期刊
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
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