The Effects of a Prospective Case Payment System on Hospital Charges for Total Hip Arthroplasty in Taiwan

Received 22 July 2005; accepted 2 December 2005.

Abstract

We evaluate the effects of instituting prospective case payment system (PPS) system on total hip arthroplasty (THA) charges and compare our university hospital THA cost structure with comparable health care institutions in the United States. The study consisted of 5009 patients who received a primary THA in 24 hospitals between 1995 and 2001. After adjusting for inflation, the average total charge of THA for pre-PPS was US$4762 and US$4054 for post-PPS. The average cost for prostheses accounted for 61% of total costs at our hospital, as compared with the US studies ranging from 27% to 34%. As United States, PPS achieved the purpose of cost containment and changed practice patterns of orthopedic surgeons and hospital resource use in Taiwan.

Key words: total hip arthroplasty, prospective case payment system, charge, cost, Taiwan

⁎ Graduate Institute of Health Care Administration, Kaohsiung Medical University, Kaohsiung, Taiwan

† School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

Reprint requests: Gwo-Jaw Wang, MD, Kaohsiung Medical University, 100 Shih-Chun 1st Road, Kaohsiung 807, Taiwan.

No benefits or funds were received in support of the study.

PII: S0883-5403(05)00693-5

doi:10.1016/j.arth.2005.12.003

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