| Title |
What is the Long-term Economic Societal Effect of Periprosthetic Infections After THA? A Markov Analysis
|
|---|---|
| Published in |
Clinical Orthopaedics & Related Research, April 2017
|
| DOI | 10.1007/s11999-017-5333-6 |
| Pubmed ID | |
| Authors |
Thomas J. Parisi, Joseph F. Konopka, Hany S. Bedair |
| Abstract |
Current estimates for the direct costs of a single episode of care for periprosthetic joint infection (PJI) after THA are approximately USD 100,000. These estimates do not account for the costs of failed treatments and do not include indirect costs such as lost wages. The goal of this study was to estimate the long-term economic effect to society (direct and indirect costs) of a PJI after THA treated with contemporary standards of care in a hypothetical patient of working age (three scenarios, age 55, 60, and 65 years). We created a state-transition Markov model with health states defined by surgical treatment options including irrigation and débridement with modular exchange, single-stage revision, and two-stage revision. Reoperation rates attributable to septic and aseptic failure modes and indirect and direct costs were calculated estimates garnered via multiple systematic reviews of peer-reviewed orthopaedic and infectious disease journals and Medicare reimbursement data. We conducted an analysis over a hypothetical patient's lifetime from the societal perspective with costs discounted by 3% annually. We conducted sensitivity analysis to delineate the effects of uncertainty attributable to input variables. The model found a base case cost of USD 390,806 per 65-year-old patient with an infected THA. One-way sensitivity analysis gives a range of USD 389,307 (65-year-old with a 3% reinfection rate) and USD 474,004 (55-year-old with a 12% reinfection rate). Indirect costs such as lost wages make up a considerable portion of the costs and increase considerably as age at the time of infection decreases. The results of this study show that the overall treatment of a periprosthetic infection after a THA is markedly more expensive to society than previously estimated when accounting for the considerable failure rates of current treatment options and including indirect costs. These overall costs, combined with a large projected increase in THAs and a steady state of septic failures, should be taken into account when considering the total cost of THA. Further research is needed to adequately compare the clinical and economic effectiveness of alternative treatment pathways. Level II, economic and decision analysis. |
X Demographics
The data shown below were collected from the profiles of 20 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 5 | 25% |
| United States | 3 | 15% |
| United Kingdom | 1 | 5% |
| Peru | 1 | 5% |
| Venezuela, Bolivarian Republic of | 1 | 5% |
| India | 1 | 5% |
| Switzerland | 1 | 5% |
| Unknown | 7 | 35% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 14 | 70% |
| Practitioners (doctors, other healthcare professionals) | 3 | 15% |
| Scientists | 2 | 10% |
| Science communicators (journalists, bloggers, editors) | 1 | 5% |
Mendeley readers
The data shown below were compiled from readership statistics for 104 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 104 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 12 | 12% |
| Researcher | 12 | 12% |
| Student > Master | 12 | 12% |
| Student > Doctoral Student | 11 | 11% |
| Student > Postgraduate | 10 | 10% |
| Other | 19 | 18% |
| Unknown | 28 | 27% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 40 | 38% |
| Engineering | 4 | 4% |
| Nursing and Health Professions | 4 | 4% |
| Economics, Econometrics and Finance | 3 | 3% |
| Business, Management and Accounting | 3 | 3% |
| Other | 15 | 14% |
| Unknown | 35 | 34% |
Attention Score in Context
This research output has an Altmetric Attention Score of 23. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 April 2019.
All research outputs
#1,620,810
of 25,382,440 outputs
Outputs from Clinical Orthopaedics & Related Research
#199
of 7,300 outputs
Outputs of similar age
#31,207
of 324,698 outputs
Outputs of similar age from Clinical Orthopaedics & Related Research
#3
of 83 outputs
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