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APHA Scientific Session and Event Listing

Recorded presentation

José Luis Navarro Espigares, PhD, Prof, Mgr¹, Hernández Torres Elisa¹, and Pedro González de la Flor, MD, PhD². (1) Economic Department, University Hospital Virgen de las Nieves, Avenida de las Fuerzas Armadas 2, Granada, 18014, Spain, +34 958 020637, josel.navarro.sspa@juntadeandalucia.es, (2) Preventive Medicine Department, University General Hospital of Jaén, Avda. del Ejército Español, 10, Jaén, 23007, Spain

BACKGROUND In developed countries with public health care systems, cost per QALY of medical procedures is accepted as criteria for priority setting. Nevertheless, QALYs gained are not known for numerous medical procedures. OBJECTIVES Our objective is to calculate the cost per QALY gained with primary hip and knee replacement and compare it with cost per QALY in other medical procedures. METHODOLOGY This is a prospective study with a sample size of 80 patients (40 of hip and 40 of knee) treated in a university hospital in Granada (Spain). The evaluation involved age, sex, clinical assessment, WOMAC instrument to assess functional status, and EuroQol to measure cost-utility. Direct costs were considered and obtained from the hospital's analytical accounting system. RESULTS The average age of patients was 72.78 (SD 10.39), and the average length of stay in the hospital was 10.18 (SD 8.10) days. 70.8% were female. QALYs gained in knee cohort were 4.3, while in hip cohort 0.9. Best results were obtained in patients over 70 years. Total cost of knee replacement was 6,865 € (1,596 € per QALY), and in hip replacement 7,891 € (8,768 € per QALY). CONCLUSIONS Knee replacement gains more QALYs and is less costly than hip replacement. The costs of both knee and hip replacement compare favorably with other medical or surgical procedures. The enlarging population of those over 65 forecasts an increase of these procedures. Minimal invasive techniques are being introduced in these procedures as a way to control the budgetary impact of this activity.

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