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.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.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.doi http://dx.doi.org/10.1016/j.healthpol.2022.02.007
• dc.identifier.issn 0168-8510
• dc.identifier.uri http://hdl.handle.net/10230/58382
• 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.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
• dc.subject.keyword Technology
• dc.subject.keyword Substitution
• dc.subject.keyword Adoption
• dc.subject.keyword Diffusion
• dc.subject.keyword Robotic surgery
• dc.title The diffusion of robotic surgery: examining technology use in the English NHS
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion