Health economics single-center analysis of 10-year trends in hip and knee replacements

doi:10.3877/ cma.j.issn.1674-134X.2025.02.002

Abstract

Abstract:

Objective

To analyze the information related to hip and knee arthroplasty in a hospital affiliated to a medical university in the past 12 years, and take this as an example to reflect the surgical trend and health economic trend of joint arthroplasty in the past decade.

Methods

The data of patients undergoing hip and knee replacement in a hospital affiliated to a medical university from 2011 to 2022 were collected and analyzed, including patients’ age, gender, length of hospital stay, main diagnosis, name of operation, treatment cost, etc., and the changes in the number of operations, age composition of patients, gender differences, length of stay and treatment costs were compared. Statistical results were analyzed by t test and logistic regression analysis.

Results

A total of 13 993 cases of hip and knee arthroplasty were studied in this study, including 8 232 cases of hip arthroplasty and 5 761 cases of knee arthroplasty. In the hip arthroplasty related operations, the annul number of hip arthroplasty cases increased by an average of 9.9%, the average age of patients was (68±13)years, male patients accounted for 42.2% and female patients accounted for 57.8%. The average length of hospital stay of patients decreased by 46.7% compared with 2011. The average cost of total treatment was 53 936 yuan, of which the cost of consumables accounted for 59.2%. Total costs were 15.9% lower than the data in 2011. The annual number of knee surgery cases in the hospital increased by an average of 10.0% year by year, the average age of patients was (70±8) years, the proportion of male patients was 30.4%, and the proportion of female patients was 69.6%. The average length of hospital stay of patients was reduced by 41.5% compared with 2013, and the average total treatment cost was 48 559 yuan, of which consumables accounted for 56.3%. The total cost was 29.6% lower than in 2013.

Conclusions

The number of patients undergoing hip and knee replacement is increasing year by year. Although the hospitalization days and hospitalization costs of patients are significantly reduced compared with previous years, patients still have a large burden of treatment costs. Reducing the cost of surgical consumables is an important link to reduce the total cost.

Key words: Hip arthroplasty, Knee arthroplasty, Health economics

Shunyu Yao, Pei Fan, Bo Zhang, Jiesheng Zhu. Health economics single-center analysis of 10-year trends in hip and knee replacements[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2025, 19(02): 143-150.

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Figures/Tables 7

Figure 1 Number of patients undergoing hip-knee arthroplasty. A shows the number of cases of hip arthroplasty; B shows the number of knee arthroplasty

Figure 2 Age distribution of patients undergoing hip-knee arthroplasty. A is age distribution of patients undergoing hip arthroplasty; B is age distribution of patients undergoing knee arthroplasty

Figure 3 Age and number of patients undergoing surgery. A shows the age and number of patients undergoing total hip arthroplasty; B shows the age and number of patients undergoing artificial femoral head arthroplasty; C shows the age and number of patients undergoing total knee arthroplasty

Figure 4 Length of hospital stay after hip-knee arthroplasty. A is the hospital stay change of hip arthroplasty; B is the hospital stay length change of knee arthroplasty

Figure 5 Distribution of patients with different hospitalization days after hip-knee arthroplasty

Figure 6 Total cost and consumables cost of hip-knee arthroplasty and their changing trend. A shows hip arthroplasty; B shows knee arthroplasty

Table 1 Comparison of basic data of patients undergoing hip/knee replacement surgery

组别Groups	例数Number of cases	性别（%） Gender		年龄［岁，（ $\overset{ˉ}{x}$ ± s ）］Age (year)	住院天数［d，（ $\overset{ˉ}{x}$ ± s ）］Hospital day	总治疗费用［元，（ $\overset{ˉ}{x}$ ± s ）］Treatment costs
组别Groups	例数Number of cases	男 Male	女 Female	年龄［岁，（ $\overset{ˉ}{x}$ ± s ）］Age (year)	住院天数［d，（ $\overset{ˉ}{x}$ ± s ）］Hospital day	总治疗费用［元，（ $\overset{ˉ}{x}$ ± s ）］Treatment costs
髋关节手术Hiparthroplasty	8 232	42. 2	57. 8	67±13	10±6	53 936±15 977
膝关节手术Knee arthroplasty	5 761	30. 4	69. 6	70±8	10±4	48 559±11 907
统计值Statistical values		髋关节组χ²=197. 786		t=-3. 206	t=6. 574	t=26. 345
		膝关节组χ²=887. 367
P值		＜0. 001		0. 001	＜0. 001	＜0. 001

Table 1 Comparison of basic data of patients undergoing hip/knee replacement surgery

组别Groups	例数Number of cases	性别（%） Gender		年龄［岁，（ $\overset{ˉ}{x}$ ± s ）］Age (year)	住院天数［d，（ $\overset{ˉ}{x}$ ± s ）］Hospital day	总治疗费用［元，（ $\overset{ˉ}{x}$ ± s ）］Treatment costs
组别Groups	例数Number of cases	男 Male	女 Female	年龄［岁，（ $\overset{ˉ}{x}$ ± s ）］Age (year)	住院天数［d，（ $\overset{ˉ}{x}$ ± s ）］Hospital day	总治疗费用［元，（ $\overset{ˉ}{x}$ ± s ）］Treatment costs
髋关节手术Hiparthroplasty	8 232	42. 2	57. 8	67±13	10±6	53 936±15 977
膝关节手术Knee arthroplasty	5 761	30. 4	69. 6	70±8	10±4	48 559±11 907
统计值Statistical values		髋关节组χ²=197. 786		t=-3. 206	t=6. 574	t=26. 345
		膝关节组χ²=887. 367
P值		＜0. 001		0. 001	＜0. 001	＜0. 001

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