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

  • Imma Latessa University Hospital of Naples “Federico II”, Department of Public Health, Naples, Italy; Reykjavík University, Institute for Biomedical and Neural Engineering, Reykjavík, Iceland.
  • Carlo Ricciardi Reykjavík University, Institute for Biomedical and Neural Engineering, Reykjavík, Iceland; University Hospital of Naples ‘Federico II’, Department of Advanced Biomedical Sciences, Naples, Italy. https://orcid.org/0000-0001-7290-6432
  • Deborah Jacob Reykjavík University, Institute for Biomedical and Neural Engineering, Reykjavík, Iceland.
  • Halldór Jónsson Jr University of Iceland, Faculty of Medicine, Reykjavík, Iceland; Landspítali Hospital, Orthopaedic Clinic, Reykjavík, Iceland.
  • Monica Gambacorta Umberto I Hospital, Local Health Unit of Salerno, Salerno, Italy.
  • Giovanni Improta University Hospital of Naples “Federico II”, Department of Public Health, Naples, Italy.
  • Paolo Gargiulo | paologar@landspitali.is Reykjavík University, Institute for Biomedical and Neural Engineering, Reykjavík, Iceland; Landspítali Hospital, Department of Science, Reykjavík, Iceland.

Abstract

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.

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Published
2021-03-09
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Original Articles
Keywords:
health technology assessment, six sigma, cost analysis, multinomial logistic regression, total hip arthroplasty
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How to Cite
Latessa, I., Ricciardi, C., Jacob, D., Jónsson Jr, H., Gambacorta, M., Improta, G., & Gargiulo, P. (2021). Health technology assessment through Six Sigma Methodology to assess cemented and uncemented protheses in total hip arthroplasty. European Journal of Translational Myology, 31(1). https://doi.org/10.4081/ejtm.2021.9651