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Application of DMAIC Cycle and Modeling as Tools for Health Technology Assessment in a University Hospital

BACKGROUND: The Health Technology Assessment (HTA) is used to evaluate health services, manage healthcare processes more efficiently, and compare medical technologies. The aim of this paper is to carry out an HTA study that compares two pharmacological therapies and provides the clinicians with two...

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Autores principales: Ponsiglione, Alfonso Maria, Ricciardi, Carlo, Scala, Arianna, Fiorillo, Antonella, Sorrentino, Alfonso, Triassi, Maria, Dell'Aversana Orabona, Giovanni, Improta, Giovanni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8387173/
https://www.ncbi.nlm.nih.gov/pubmed/34457223
http://dx.doi.org/10.1155/2021/8826048
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author Ponsiglione, Alfonso Maria
Ricciardi, Carlo
Scala, Arianna
Fiorillo, Antonella
Sorrentino, Alfonso
Triassi, Maria
Dell'Aversana Orabona, Giovanni
Improta, Giovanni
author_facet Ponsiglione, Alfonso Maria
Ricciardi, Carlo
Scala, Arianna
Fiorillo, Antonella
Sorrentino, Alfonso
Triassi, Maria
Dell'Aversana Orabona, Giovanni
Improta, Giovanni
author_sort Ponsiglione, Alfonso Maria
collection PubMed
description BACKGROUND: The Health Technology Assessment (HTA) is used to evaluate health services, manage healthcare processes more efficiently, and compare medical technologies. The aim of this paper is to carry out an HTA study that compares two pharmacological therapies and provides the clinicians with two models to predict the length of hospital stay (LOS) of patients undergoing oral cavity cancer surgery on the bone tissue. METHODS: The six Sigma method was used as a tool of HTA; it is a technique of quality management and process improvement that combines the use of statistics with a five-step procedure: “Define, Measure, Analyze, Improve, Control” referred to in the acronym DMAIC. Subsequently, multiple linear regression has been used to create two models. Two groups of patients were analyzed: 45 were treated with ceftriaxone while 48 were treated with the combination of cefazolin and clindamycin. RESULTS: A reduction of the overall mean LOS of patients undergoing oral cavity cancer surgery on bone was observed of 40.9% in the group treated with ceftriaxone. Its reduction was observed in all the variables of the ceftriaxone group. The best results are obtained in younger patients (−54.1%) and in patients with low oral hygiene (−52.4%) treated. The regression results showed that the best LOS predictors for cefazolin/clindamycin are ASA score and flap while for ceftriaxone, in addition to these two, oral hygiene and lymphadenectomy are the best predictors. In addition, the adjusted R squared showed that the variables considered explain most of the variance of LOS. CONCLUSION: SS methodology, used as an HTA tool, allowed us to understand the performance of the antibiotics and provided variables that mostly influence postoperative LOS. The obtained models can improve the outcome of patients, reducing the postoperative LOS and the relative costs, consequently increasing patient safety, and improving the quality of care provided.
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spelling pubmed-83871732021-08-26 Application of DMAIC Cycle and Modeling as Tools for Health Technology Assessment in a University Hospital Ponsiglione, Alfonso Maria Ricciardi, Carlo Scala, Arianna Fiorillo, Antonella Sorrentino, Alfonso Triassi, Maria Dell'Aversana Orabona, Giovanni Improta, Giovanni J Healthc Eng Research Article BACKGROUND: The Health Technology Assessment (HTA) is used to evaluate health services, manage healthcare processes more efficiently, and compare medical technologies. The aim of this paper is to carry out an HTA study that compares two pharmacological therapies and provides the clinicians with two models to predict the length of hospital stay (LOS) of patients undergoing oral cavity cancer surgery on the bone tissue. METHODS: The six Sigma method was used as a tool of HTA; it is a technique of quality management and process improvement that combines the use of statistics with a five-step procedure: “Define, Measure, Analyze, Improve, Control” referred to in the acronym DMAIC. Subsequently, multiple linear regression has been used to create two models. Two groups of patients were analyzed: 45 were treated with ceftriaxone while 48 were treated with the combination of cefazolin and clindamycin. RESULTS: A reduction of the overall mean LOS of patients undergoing oral cavity cancer surgery on bone was observed of 40.9% in the group treated with ceftriaxone. Its reduction was observed in all the variables of the ceftriaxone group. The best results are obtained in younger patients (−54.1%) and in patients with low oral hygiene (−52.4%) treated. The regression results showed that the best LOS predictors for cefazolin/clindamycin are ASA score and flap while for ceftriaxone, in addition to these two, oral hygiene and lymphadenectomy are the best predictors. In addition, the adjusted R squared showed that the variables considered explain most of the variance of LOS. CONCLUSION: SS methodology, used as an HTA tool, allowed us to understand the performance of the antibiotics and provided variables that mostly influence postoperative LOS. The obtained models can improve the outcome of patients, reducing the postoperative LOS and the relative costs, consequently increasing patient safety, and improving the quality of care provided. Hindawi 2021-08-17 /pmc/articles/PMC8387173/ /pubmed/34457223 http://dx.doi.org/10.1155/2021/8826048 Text en Copyright © 2021 Alfonso Maria Ponsiglione et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Ponsiglione, Alfonso Maria
Ricciardi, Carlo
Scala, Arianna
Fiorillo, Antonella
Sorrentino, Alfonso
Triassi, Maria
Dell'Aversana Orabona, Giovanni
Improta, Giovanni
Application of DMAIC Cycle and Modeling as Tools for Health Technology Assessment in a University Hospital
title Application of DMAIC Cycle and Modeling as Tools for Health Technology Assessment in a University Hospital
title_full Application of DMAIC Cycle and Modeling as Tools for Health Technology Assessment in a University Hospital
title_fullStr Application of DMAIC Cycle and Modeling as Tools for Health Technology Assessment in a University Hospital
title_full_unstemmed Application of DMAIC Cycle and Modeling as Tools for Health Technology Assessment in a University Hospital
title_short Application of DMAIC Cycle and Modeling as Tools for Health Technology Assessment in a University Hospital
title_sort application of dmaic cycle and modeling as tools for health technology assessment in a university hospital
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8387173/
https://www.ncbi.nlm.nih.gov/pubmed/34457223
http://dx.doi.org/10.1155/2021/8826048
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