Advertisement

Atlantic Economic Journal

, Volume 45, Issue 4, pp 473–484 | Cite as

Diffusion of Minimally Invasive Procedures across Hospitals and Traits of Fast Adopting Hospitals

  • Ashley HodgsonEmail author
  • Chloe Mitchell
  • Alec Paulson
Article
  • 94 Downloads

Abstract

The quality and cost of hospital care depends not only on what technologies have been developed, but on how quickly the most promising and cost-effective technologies diffuse across hospitals. Some technologies are high-cost when they are first introduced into the health care system, but improve in cost-effectiveness as doctors use the technologies and innovate. Some such examples are minimally invasive procedures, which have become more common in recent years. We sought to better understand what hospital characteristics are associated with fast adoption of four minimally invasive procedures (appendectomy, lobectomy, hysterectomy and colectomy). Our findings show that a hospital’s adoption of minimally invasive procedures in one type of procedure (e.g., lobectomy) is not predictive of that hospital’s probability of adopting minimally invasive procedures in another procedure type (e.g., zero appendectomies). The only hospital characteristic consistently correlated with adoption for three of the four procedure types was the extent that the hospital’s geographic neighbors had adopted minimally invasive technology for that particular procedure. These findings regarding peer effects fall in line with conclusions about diffusion from the development literature.

Keywords

Diffusion Medical technology Hospitals 

JEL

I00 

References

  1. Angst, C. M., Agarwal, R., Sambamurthy, V., & Kelley, K. (2010). Social contagion and information technology diffusion: the adoption of electronic medical records in US hospitals. Management Science, 56(8), 1219–1241.CrossRefGoogle Scholar
  2. Bandiera, O., & Rasul, I. (2006). Social networks and technology adoption in northern Mozambique. The Economic Journal, 116(514), 869–902.CrossRefGoogle Scholar
  3. Barnett, J. C., Judd, J. P., Wu, J. M., Scales Jr., C. D., Myers, E. R., & Havrilesky, L. J. (2010). Cost comparison among robotic, laparoscopic, and open hysterectomy for endometrial cancer. Obstetrics & Gynecology, 116(3), 685–693.CrossRefGoogle Scholar
  4. Biere, S. S., van Berge Henegouwen, M. I., Maas, K. W., Bonavina, L., Rosman, C., Garcia, J. R., et al. (2012). Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial. The Lancet, 379(9829), 1887–1892.CrossRefGoogle Scholar
  5. Buntin, M. B., Burke, M. F., Hoaglin, M. C., & Blumenthal, D. (2011). The benefits of health information technology: a review of the recent literature shows predominantly positive results. Health Affairs, 30(3), 464–471.CrossRefGoogle Scholar
  6. Burke, D., Wang, B., Wan, T. T., & Diana, M. (2002). Exploring hospitals' adoption of information technology. Journal of Medical Systems, 26(4), 349–355.CrossRefGoogle Scholar
  7. Chandra, A., & Skinner, J. (2012). Technology growth and expenditure growth in health care. Journal of Economic Literature, 50(3), 645–680.CrossRefGoogle Scholar
  8. Christensen, C. M., Grossman, J. H., & Hwang, J. (2009). The innovator’s prescription: a disruptive solution for health care. New York: McGraw-Hill.Google Scholar
  9. Conley, T. G., & Udry, C. R. (2010). Learning about a new technology: pineapple in Ghana. The American Economic Review, 100(1), 35–69.CrossRefGoogle Scholar
  10. Cooper, M. A., Hutfless, S., Segev, D. L., Ibrahim, A., Lyu, H., & Makary, M. A. (2014). Hospital level under-utilization of minimally invasive surgery in the United States: retrospective review. British Medical Journal, 349, g4198.CrossRefGoogle Scholar
  11. Dartmouth Atlas (2017). The Dartmouth Atlas of Health Care. Accessed 16 August 2017. http://www.dartmouthatlas.org/data/region/.
  12. Demoulin, L., Kesteloot, K., & Penninckx, F. (1996). A cost comparison of disposable vs reusable instruments in laparoscopic cholecystectomy. Surgical Endoscopy, 10(5), 520–525.CrossRefGoogle Scholar
  13. Friedman, B., Devers, K. J., Steiner, C. A., & Fox, S. (2002). The use of expensive health technologies in the era of managed care: the remarkable case of neonatal intensive care. Journal of Health Politics, Policy and Law, 27(3), 441–464.CrossRefGoogle Scholar
  14. Fullum, T. M., Ladapo, J. A., Borah, B. J., & Gunnarsson, C. L. (2010). Comparison of the clinical and economic outcomes between open and minimally invasive appendectomy and colectomy: evidence from a large commercial payer database. Surgical Endoscopy, 24(4), 845–853.CrossRefGoogle Scholar
  15. Furukawa, M. F., Raghu, T., Spaulding, T. J., & Vinze, A. (2008). Adoption of health information technology for medication safety in US hospitals, 2006. Health Affairs, 27(3), 865–875.CrossRefGoogle Scholar
  16. Howard, D., Brophy, R., & Howell, S. (2012). Evidence of no benefit from knee surgery for osteoarthritis led to coverage changes and is linked to decline in procedures. Health Affairs, 31(10), 2242–2249.CrossRefGoogle Scholar
  17. Hu, J. C., Gu, X., Lipsitz, S. R., Barry, M. J., D’Amico, A. V., Weinberg, A. C., et al. (2009). Comparative effectiveness of minimally invasive vs open radical prostatectomy. Journal of the American Medical Association, 302(14), 1557–1564.CrossRefGoogle Scholar
  18. Jha, A. K., DesRoches, C. M., Campbell, E. G., Donelan, K., Rao, S. R., Ferris, T. G., et al. (2009a). Use of electronic health records in US hospitals. New England Journal of Medicine, 360(16), 1628–1638.CrossRefGoogle Scholar
  19. Jha, A. K., DesRoches, C. M., Shields, A. E., Miralles, P. D., Zheng, J., Rosenbaum, S., et al. (2009b). Evidence of an emerging digital divide among hospitals that care for the poor. Health Affairs, 28(6), w1160–w1170.CrossRefGoogle Scholar
  20. Judd, J. P., Siddiqui, N. Y., Barnett, J. C., Visco, A. G., Havrilesky, L. J., & Wu, J. M. (2010). Cost-minimization analysis of robotic-assisted, laparoscopic, and abdominal sacrocolpopexy. Journal of Minimally Invasive Gynecology, 17(4), 493–499.CrossRefGoogle Scholar
  21. Kazley, A. S., & Ozcan, Y. A. (2007). Organizational and environmental determinants of hospital EMR adoption: a national study. Journal of Medical Systems, 31(5), 375–384.CrossRefGoogle Scholar
  22. King, J., Furukawa, M. F., & Buntin, M. B. (2013). Geographic variation in ambulatory electronic health record adoption: implications for underserved communities. Health Services Research, 48(6pt1), 2037–2059.Google Scholar
  23. Kolata, G. (2010). Results unproven, robotic surgery wins converts. The New York times Google Scholar
  24. Lenihan, J. P., Kovanda, C., & Seshadri-Kreaden, U. (2008). What is the learning curve for robotic assisted gynecologic surgery? Journal of Minimally Invasive Gynecology, 15(5), 589–594.CrossRefGoogle Scholar
  25. Li, H., Gail, M. H., Braithwaite, R. S., Gold, H. T., Walter, D., Liu, M., et al. (2014). Are hospitals “keeping up with the Joneses”?: Assessing the spatial and temporal diffusion of the surgical robot. Healthcare, 2(2), 152–157.CrossRefGoogle Scholar
  26. Lin, N.-C., Nitta, H., & Wakabayashi, G. (2013). Laparoscopic major hepatectomy: a systematic literature review and comparison of 3 techniques. Annals of Surgery, 257(2), 205–213.CrossRefGoogle Scholar
  27. McCullough, J. S. (2008). The adoption of hospital information systems. Health Economics, 17(5), 649–664.CrossRefGoogle Scholar
  28. Menachemi, N., Matthews, M. C., Ford, E. W., & Brooks, R. G. (2007). The influence of payer mix on electronic health record adoption by physicians. Health Care Management Review, 32(2), 111–118.CrossRefGoogle Scholar
  29. Morgan, J. A., Thornton, B. A., Peacock, J. C., Hollingsworth, K. W., Smith, C. R., Oz, M. C., et al. (2005). Does robotic technology make minimally invasive cardiac surgery too expensive? A hospital cost analysis of robotic and conventional techniques. Journal of Cardiac Surgery, 20(3), 246–251.CrossRefGoogle Scholar
  30. Murray, A., Lourenco, T., De Verteuil, R., Hernandez, R., Fraser, C., McKinley, A., et al. (2006). Clinical effectiveness and cost-effectiveness of laparoscopic surgery for colorectal cancer: systematic reviews and economic evaluation. Health Technology Assessment, 10(45), 141.CrossRefGoogle Scholar
  31. Najaftorkaman, M., Ghapanchi, A. H., Talaei-Khoei, A., & Ray, P. (2015). A taxonomy of antecedents to user adoption of health information systems: a synthesis of thirty years of research. Journal of the Association for Information Science and Technology, 66(3), 576–598.CrossRefGoogle Scholar
  32. Orszag, P. R. (2008). CBO testimony statement of Peter R. Orszag "Growth in health care costs", January 31, 2008. Washington, D.C.: United States Congressional Budget Office. https://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/89xx/doc8948/01-31-healthtestimony.pdf. Accessed 15 Aug 2017.
  33. OSHPD Office of Statewide Health Planning and Development (2003–2011). Patient discharge data. Accessed 16 August 2017. https://www.oshpd.ca.gov/HID/Patient-Discharge-Data.html.
  34. Pisano, G. P., Bohmer, R. M., & Edmondson, A. C. (2001). Organizational differences in rates of learning: Evidence from the adoption of minimally invasive cardiac surgery. Management Science, 47(6), 752–768.CrossRefGoogle Scholar
  35. Roumm, A. R., Pizzi, L., Goldfarb, N. I., & Cohn, H. (2005). Minimally invasive: minimally reimbursed? An examination of six laparoscopic surgical procedures. Surgical Innovation, 12(3), 261–287.CrossRefGoogle Scholar
  36. Sabik, L. M. (2012). The effect of community uninsurance rates on access to health care. Health Services Research, 47(3pt1), 897–918.Google Scholar
  37. Shields, A. E., Shin, P., Leu, M. G., Levy, D. E., Betancourt, R. M., Hawkins, D., et al. (2007). Adoption of health information technology in community health centers: results of a national survey. Health Affairs, 26(5), 1373–1383.CrossRefGoogle Scholar
  38. Singer, E. (2010). The slow rise of the robot surgeon. MIT Technology Review. https://www.technologyreview.com/s/418141/the-slow-rise-of-the-robot-surgeon/. Accessed 15 Aug 2017.
  39. Skinner, J., & Staiger, D. (2015). Technology diffusion and productivity growth in health care. Review of Economics and Statistics, 97(5), 951–964.CrossRefGoogle Scholar
  40. Verhage, R. J., Hazebroek, E., Boone, J., & Van Hillegersberg, R. (2009). Minimally invasive surgery compared to open procedures in esophagectomy for cancer: a systematic review of the literature. Minerva Chirurgica, 64(2), 135.Google Scholar
  41. Winter, D. (2009). The cost of laparoscopic surgery is the price of progress. British Journal of Surgery, 96(4), 327–328.CrossRefGoogle Scholar
  42. Wulff, K. C., Miller, F. G., & Pearson, S. D. (2011). Can coverage be rescinded when negative trial results threaten a popular procedure? The ongoing saga of vertebroplasty. Health Affairs, 30(12), 2269–2276.CrossRefGoogle Scholar
  43. Young, H. P. (2009). Innovation diffusion in heterogeneous populations: contagion, social influence, and social learning. The American Economic Review, 99(5), 1899–1924.CrossRefGoogle Scholar
  44. Zwanziger, J., Melnick, G. A., & Mann, J. M. (1990). Measures of hospital market structure: a review of the alternatives and a proposed approach. Socio-Economic Planning Sciences, 24(2), 81–95.CrossRefGoogle Scholar

Copyright information

© International Atlantic Economic Society 2017

Authors and Affiliations

  1. 1.St. Olaf CollegeNorthfieldUSA
  2. 2.The Lewin GroupFalls ChurchUSA
  3. 3.Analysis Group, Boston OfficeBostonUSA

Personalised recommendations