European journal of medical research
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Total hip arthroplasty (THA) is an established and cost effective procedure in the treatment of severe arthritis of the hip. However, bearing recent demographic changes in mind, the increasing demand for total hip arthroplasty during the next decades catalyzes health economic re-consideration of the overall health care process of initial surgery and subsequent rehabilitation. One point for discussion is due to postoperative rehabilitation, since direct costs of the latter crucially depend on whether in-patient (indoor) or out-patient (outdoor) rehabilitation is recommended. Whereas out-patient rehabilitation is obviously more cost efficient from a health insurer's perspective than its indoor alternative, it is open for discussion, whether the alternatives' clinical benefit profiles from a patient's perspective are of comparable order. Therefore this pilot investigation was implemented to assess the clinical benefit and cost effectiveness of in-patient versus out-patient rehabilitation after THA. ⋯ In this matched pilot investigation the overall health care process involving in-patient rehabilitation after total hip arthroplasty did not demonstrate a significantly superior cost effectiveness when compared to its out-patient alternative from a health care insurer's perspective. This observation is complemented by a rather small difference in clinical benefit. However, prospective investigations, which should randomize the rehabilitation alternatives onto appropriate patients, are necessary to confirm the above pilot results.