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The diffusion of robotic surgery: examining technology use in the English NHS

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dc.contributor.author Maynou Pujolràs, Laia
dc.contributor.author Pearson, Georgia
dc.contributor.author McGuire, Alistair
dc.contributor.author Serra-Sastre, Victoria
dc.date.accessioned 2023-11-27T11:28:27Z
dc.date.available 2023-11-27T11:28:27Z
dc.date.issued 2022
dc.identifier.citation Maynou L, Pearson G, McGuire A, Serra-Sastre V. The diffusion of robotic surgery: examining technology use in the English NHS. Health Policy. 2022 Apr;126(4):325-36. DOI: 10.1016/j.healthpol.2022.02.007
dc.identifier.issn 0168-8510
dc.identifier.uri http://hdl.handle.net/10230/58382
dc.description.abstract This paper examines the adoption and diffusion of medical technology as associated with the dramatic recent increase in the surgical use of robots. We consider specifically the sequential adoption and diffusion patterns of three interrelated surgical technologies within a single healthcare system (the English NHS): robotic, laparoscopic and open radical prostatectomy. Robotic and laparoscopic techniques are minimally invasive procedures with similar patient benefits, but the newer robotic technique requires a high initial investment cost to purchase the robot and carries high maintenance costs over time. Using data from a large UK administrative database, Hospital Episodes Statistics, for the period 2000–2018, we analyse 173 hospitals performing radical prostatectomy, the most prevalent and earliest surgical area of adoption of robotic surgery. Our empirical analysis first identifies substitution effects, with robotic surgery replacing the incumbent technology, including the recently diffused laparoscopic technology. We then quantify the spillover of robotic surgery as it diffuses to other surgical specialties. Finally, we perform time-to-event analysis at the hospital level to quantitatively examine the adoption. Results show that a higher number of urologists and a wealthier referral area favor robot adoption.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartof Health Policy. 2022 Apr;126(4):325-36
dc.rights © 2022 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.title The diffusion of robotic surgery: examining technology use in the English NHS
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1016/j.healthpol.2022.02.007
dc.subject.keyword Technology
dc.subject.keyword Substitution
dc.subject.keyword Adoption
dc.subject.keyword Diffusion
dc.subject.keyword Robotic surgery
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion


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