Development of a System Dynamics Model for Cost Estimation for the Implantation and Revision of Hip Joint Endoprosthesis

摘要

The increasing population, particularly regarding the proportion of people over the age of 60 causes new challenges to public health care systems. Simulations of existing health care models indicate that especially orthopedic and arthritic conditions show a considerable impact of population aging on total health care costs. To demonstrate the estimated total amount of costs, a model was developed in this work, which allows simulating the costs regarding hip joint endoprosthesis. The benefit of this model will be the chance to compare the results of different simulation scenarios to each other, with regard to their economic effectiveness. The model simulates the number of implantations as well as revisions of total and part hip endoprosthesis and the incurred costs, based on real statistical data, until the year 2040. For modeling the system dynamic technique was used. To calculate the distribution of the population with a hip implant the parameters rate of implantation, type of implant, mortality and the rate of revision have been considered. The model incorporates 898 elements of which 133 represent adjustable variables. As a result of these properties, a wide range of different simulation scenarios can be investigated, such as scenarios based on capacity limits, changes in implantation and revision times, variations in implant costs, expense-related costs or changes in the allocation of cemented and un-cemented implants as well as bearing combinations. Therefore the model can be enhanced by adapting it for future developments. The model presented in this paper represents a comprehensive tool, which for the first time enables a lot of possibilities for different simulation scenarios in the medical area of hip arthroplasty regarding cost estimations and resource management.