Total hip arthroplasty (THA) is an orthopedic intervention that generates substantial costs to national healthcare systems due to the number of interventions and the cost per intervention. We performed a cost comparison analysis in Austria and Switzerland.

Data from the national joint arthroplasty register in Switzerland and internal information from the national healthcare services in Austria and Switzerland were compared for patient demographics, interventional characteristics, and costs adjusted for inflation and purchasing power from 2015 to 2021.

The average age for primary THA in Austria was from 67.4 to 67.8 years with 55.9–57.2 percent female patients and from 68.5 to 69.3 years with 52.4–53.8 percent female patients in Switzerland. The annual incidence rate for primary THA rose from 210.28/100k to 216.6/100k in Austria and from 212/100k to 250/100k in Switzerland. After correction for inflation, costs were −1.91 percent lower in Austria in 2021 than in 2015 and −2.57 percent lower in Switzerland. After correction for purchasing power, costs were higher in Austria. The average hospital stay after THA in Austria was reduced by 20 percent (11.7 days/2015 vs. 9.4 days/2021) and 25 percent in Switzerland (8.4 days/2015 vs. 6.4 days/2021). Revision rate was 2.5–3.2 percent in Austria and 2.8–3.2 percent in Switzerland.

The patient population was comparable while patients undergoing primary THA in Austria stay longer in hospital and have relatively higher costs when adjusted for currency, purchasing power, and inflation. The use of standardized registers would be helpful to compare outcomes and costs.