Health Technology Assessment Through the Six Sigma Approach in Abdominoplasty: Scalpel vs Electrosurgery

2021 ◽  
Author(s):  
C. Ricciardi ◽  
A. Gubitosi ◽  
G. Lanzano ◽  
S. Parisi ◽  
E. Grella ◽  
...  
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Six Sigma ◽  
Health Technology ◽  
Six Sigma Approach

scholarly journals Health technology assessment through Six Sigma Methodology to assess cemented and uncemented protheses in total hip arthroplasty

2021 ◽  
Author(s):  
Imma Latessa ◽  
Carlo Ricciardi ◽  
Deborah Jacob ◽  
Halldór Jónsson Jr ◽  
Monica Gambacorta ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Total Hip Arthroplasty ◽  
Health Technology Assessment ◽  
Hip Arthroplasty ◽  
Technology Assessment ◽  
Six Sigma ◽  
Multinomial Logistic Regression ◽  
Health Technology ◽  
Uncemented Prosthesis ◽  
The Cost

The purpose of this study is to use Health Technology Assessment (HTA) through the Six Sigma (SS) and DMAIC (Define, Measure, Analyse, Improve, Control) problem-solving strategies for comparing cemented and uncemented prostheses in terms of the costs incurred for Total hip arthroplasty (THA) and the length of hospital stay (LOS). Multinomial logistic regression analysis for modelling the data was also performed. Quantitative parameters extracted from gait analysis, electromyography and computed tomography images were used to compare the approaches, but the analysis did not show statistical significance. The variables regarding costs were studied with the Mann-Whitney and Kruskal-Wallis tests. No statistically significant difference between cemented and uncemented prosthesis for the total cost of LOS was found, but the cost of the surgeon had an influence on the overall expenses, affecting the cemented prosthetic approach. The material costs of surgery for the uncemented prosthesis and the cost of theatre of surgery for the cemented prosthesis were the most influential. Multinomial logistic regression identified the Vastus Lateralis variable as statistically significant. The overall accuracy of the model is 93.0%. The use of SS and DMAIC cycle as tools of HTA proved that the cemented and uncemented approaches for THA have similar costs and LOSy.

scholarly journals A Health Technology Assessment in Maxillofacial Cancer Surgery by Using the Six Sigma Methodology

2021 ◽  
Vol 18 (18) ◽  
pp. 9846
Author(s):  
Carlo Ricciardi ◽  
Giovanni Dell’Aversana Orabona ◽  
Ilaria Picone ◽  
Imma Latessa ◽  
Antonella Fiorillo ◽  
...  
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Six Sigma ◽  
Length Of Hospital Stay ◽  
Health Technology ◽  
Cancer Surgery ◽  
Future Research ◽  
P Value ◽  
Six Sigma Methodology ◽  
American Society

Squamous cell carcinoma represents the most common cancer affecting the oral cavity. At the University of Naples “Federico II”, two different antibiotic protocols were used in patients undergoing oral mucosa cancer surgery from 2006 to 2018. From 2011, there was a shift; the combination of Cefazolin plus Clindamycin as a postoperative prophylactic protocol was chosen. In this paper, a health technology assessment (HTA) is performed by using the Six Sigma and DMAIC (Define, Measure, Analyse, Improve, Control) cycle in order to compare the performance of the antibiotic protocols according to the length of hospital stay (LOS). The data (13 variables) of two groups were collected and analysed; overall, 136 patients were involved. The American Society of Anaesthesiologist score, use of lymphadenectomy or tracheotomy and the presence of infections influenced LOS significantly (p-value < 0.05) in both groups. Then, the groups were compared: the overall difference between LOS of the groups was not statistically significant, but some insights were provided by comparing the LOS of the groups according to each variable. In conclusion, in light of the insights provided by this study regarding the comparison of two antibiotic protocols, the utilization of DMAIC cycle and Six Sigma tools to perform HTA studies could be considered in future research.

scholarly journals A health technology assessment between two pharmacological therapies through Six Sigma: the case study of bone cancer

2020 ◽  
Vol 32 (6) ◽  
pp. 1507-1524 ◽  
Author(s):  
Carlo Ricciardi ◽  
Alfonso Sorrentino ◽  
Giovanni Improta ◽  
Vincenzo Abbate ◽  
Imma Latessa ◽  
...  
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Six Sigma ◽  
Maxillofacial Surgery ◽  
Health Technology ◽  
University Hospital ◽  
Healthcare Sector ◽  
Main Theme ◽  
Content Type ◽  
Hospitalization Costs

PurposeHead and neck cancers are multi-factorial diseases that can affect many sides of people's life and are due to a lot of risk factors. According to their characteristics, the treatment can be surgical, use of radiation or chemotherapy. The use of a surgical treatment can lead to surgical infections that are a main theme in medicine. At the University hospital of Naples “Federico II”, two antibiotics were employed to tackle the issue of the infections and they are compared in this paper to find which one implies the lowest length of hospital stay (LOS) and the reduction of infections.Design/methodology/approachThe Six Sigma methodology and its problem-solving strategy DMAIC (define, measure, analyse, improve, control), already employed in the healthcare sector, were used as a tool of a health technology assessment between two drugs. In this paper the DMAIC roadmap is used to compare the Ceftriaxone (administered to a group of 48 patients) and the association of Cefazolin plus Clindamycin (administered to a group of 45 patients).FindingsThe results show that the LOS of patients treated with Ceftriaxone is lower than those who were treated with the association of Cefazolin plus Clindamycin, the difference is about 41%. Moreover, a lower number of complications and infections was found in patients who received Ceftriaxone. Finally, a greater number of antibiotic shifts was needed by patients treated with Cefazolin plus Clindamycin.Research limitations/implicationsWhile the paper enhances clearly the advantages for patients' outcomes regarding the LOS and the number of complications, it did not analyse the costs of the two antibiotics.Practical implicationsEmploying the Ceftriaxone would allow the Department of Maxillofacial Surgery to obtain lower LOS and a limited number of complications/infections for recovered patients, consequently reducing the hospitalization costs.Originality/valueThere is a double value in this paper: first of all, the comparison between the two antibiotics gives an answer to one of the main issues in medicine that is the reduction of hospital-acquired infections; secondly, the Six Sigma through its DMAIC cycle can be employed also to compare two biomedical technologies as a tool of health technology assessment studies.

scholarly journals A Six Sigma DMAIC methodology as a support tool for Health Technology Assessment of two antibiotics

2021 ◽  
Vol 18 (4) ◽  
pp. 3469-3490
Author(s):  
Alfonso Maria Ponsiglione ◽  
◽  
Carlo Ricciardi ◽  
Giovanni Improta ◽  
Giovanni Dell'Aversana Orabona ◽  
...  
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Six Sigma ◽  
Health Technology ◽  
Support Tool

Versorgungsforschung in der Klinischen Neuropsychologie – eine Standortbestimmung

2008 ◽  
Vol 19 (4) ◽  
pp. 253-269 ◽  
Author(s):  
Sabine Heel ◽  
Sonja Fischer ◽  
Stefan Fischer ◽  
Tobias Grässer ◽  
Ellen Hämmerling ◽  
...  
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Empirische Forschung

Zunächst führt dieser Artikel in die wesentlichen Begrifflichkeiten und Zielstellungen der Versorgungsforschung ein. Er befasst sich dann mit der Frage, wie die einzelnen Teildisziplinen der Versorgungsforschung, (1) die Bedarfsforschung, (2) die Inanspruchnahmeforschung, (3) die Organisationsforschung, (4) das Health Technology Assessment, (5) die Versorgungsökonomie, (6) die Qualitätsforschung und zuletzt (7) die Versorgungsepidemiologie konzeptionell zu fassen sind, und wie sie für neuropsychologische Anliegen ausformuliert werden müssen. In diesem Zusammenhang werden die in den einzelnen Bereichen jeweils vorliegenden versorgungsrelevanten Studienergebnisse referiert. Soweit es zulässig ist, werden Bedarfe für die Versorgungsforschung und Versorgungspraxis in der Neurorehabilitation daraus abgeleitet und Anregungen für die weitere empirische Forschung formuliert. Der Artikel bezieht sich – entsprechend seines Anliegens – ausschließlich auf Studien, die sich mit der Situation der deutschen Neurorehabilitation befassen.

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