Factors influencing the cost of prosthetic joint infection treatment

T. N. Peel, A. C. Cheng, Y. P. Lorenzo, D. C. M. Kong, K. L. Buising, P. F. M. Choong

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Prosthetic joint infection (PJI) is associated with significant costs to the healthcare system. Current literature examines the cost of specific treatment modalities without assessing other cost drivers for PJI. Aims: To examine the overall cost of the treatment of PJI and to identify factors associated with management costs. Methods: The costs of treatment of prosthetic joint infections were examined in 139 patients across 10 hospitals over a 3-year period (January 2006 to December 2008). Cost calculations included hospitalization costs, surgical costs, hospital-in-the-home costs and antibiotic therapy costs. Negative binomial regression analysis was performed to model factors associated with total cost. Findings: The median cost of treating prosthetic joint infection per patient was Australian 34,800 (interquartile range: 20,305, 56,929). The following factors were associated with increased treatment costs: septic revision arthroplasty (67 increase in treatment cost; P=0.02), hypotension at presentation (70 increase; P=0.03), polymicrobial infections (41 increase; P=0.009), surgical treatment with one-stage exchange (100 increase; P=0.002) or resection arthroplasty (48 increase; P=0.001) were independently associated with increased treatment costs. Culture-negative prosthetic joint infections were associated with decreased costs (29 decrease in treatment cost; P=0.047). Treatment failure was associated with 156 increase in treatment costs. Conclusions: This study identifies clinically important factors influencing treatment costs that may be of relevance to policy-makers, particularly in the setting of hospital reimbursement and guiding future research into cost-effective preventive strategies.
Original languageEnglish
Pages (from-to)213 - 219
Number of pages7
JournalJournal of Hospital Infection
Issue number3
Publication statusPublished - 2013


  • Costs
  • Prosthetic joint infection
  • Treatment

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