Impacts of national centralized procurement on willingness to undergo total knee arthroplasty in China: a propensity score matching analysis of 6522 patients.

Abstract

This study aimed to evaluate the changes in hospitalization costs of patients with advanced knee osteoarthritis under the centralized procurement policy of artificial joint prostheses in China and to determine whether these changes are related to patients' willingness to undergo surgery. A total of 7189 patients with advanced knee osteoarthritis who visited the orthopaedic outpatient department of XXXX Hospital from May 2020 to April 2024 were included in this study. Patients were categorized into a control group according to the implementation timing of the national centralized procurement and a National Centralized Procurement Group (NCP group). Data recorded included the patient's sex, age, date of treatment, decision to undergo surgical treatment, and for patients did, hospitalized expenditures and related composition, length of hospital stay, duration of surgery, and type of medical insurance. Of the 7189 patients included, 3427 were categorized into the control group and 3762 patients into the NCP group. A total of 3261 pairs of patients were successfully matched using the propensity score matching (PSM) method. Surgical intervention was received by 1374 patients (42.1%) in the control group and 1662(51.0%) in the centralized procurement group. Pearson's chi-square test revealed a significant difference in surgical intention between the two groups (P < 0.001). Comparison of pre- and post-centralized procurement data for patients who underwent surgery showed a significant reduction in hospitalized expendituresand consumable costs after the introduction of centralized procurement (P < 0.001). The centralized procurement policy for artificial joint prostheses introduced in China has significantly reduced hospitalization expenditures for patients with advanced knee osteoarthritis and has increased their willingness to undergo surgery.