Skip to main content
SpringerLink
Log in

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

  • Published:
Atlantic Economic Journal Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • 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.

    Article  Google Scholar 

  • Bandiera, O., & Rasul, I. (2006). Social networks and technology adoption in northern Mozambique. The Economic Journal, 116(514), 869–902.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Burke, D., Wang, B., Wan, T. T., & Diana, M. (2002). Exploring hospitals' adoption of information technology. Journal of Medical Systems, 26(4), 349–355.

    Article  Google Scholar 

  • Chandra, A., & Skinner, J. (2012). Technology growth and expenditure growth in health care. Journal of Economic Literature, 50(3), 645–680.

    Article  Google Scholar 

  • 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 

  • Conley, T. G., & Udry, C. R. (2010). Learning about a new technology: pineapple in Ghana. The American Economic Review, 100(1), 35–69.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Dartmouth Atlas (2017). The Dartmouth Atlas of Health Care. Accessed 16 August 2017. http://www.dartmouthatlas.org/data/region/.

  • Demoulin, L., Kesteloot, K., & Penninckx, F. (1996). A cost comparison of disposable vs reusable instruments in laparoscopic cholecystectomy. Surgical Endoscopy, 10(5), 520–525.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

  • Kolata, G. (2010). Results unproven, robotic surgery wins converts. The New York times

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • McCullough, J. S. (2008). The adoption of hospital information systems. Health Economics, 17(5), 649–664.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

  • 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.

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Sabik, L. M. (2012). The effect of community uninsurance rates on access to health care. Health Services Research, 47(3pt1), 897–918.

  • 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.

    Article  Google Scholar 

  • 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.

  • Skinner, J., & Staiger, D. (2015). Technology diffusion and productivity growth in health care. Review of Economics and Statistics, 97(5), 951–964.

    Article  Google Scholar 

  • 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 

  • Winter, D. (2009). The cost of laparoscopic surgery is the price of progress. British Journal of Surgery, 96(4), 327–328.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Young, H. P. (2009). Innovation diffusion in heterogeneous populations: contagion, social influence, and social learning. The American Economic Review, 99(5), 1899–1924.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. St. Olaf College, Northfield, MN, USA

    Ashley Hodgson

  2. The Lewin Group, Falls Church, VA, USA

    Chloe Mitchell

  3. Analysis Group, Boston Office, Boston, MA, USA

    Alec Paulson

Authors
  1. Ashley Hodgson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chloe Mitchell
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alec Paulson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ashley Hodgson.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hodgson, A., Mitchell, C. & Paulson, A. Diffusion of Minimally Invasive Procedures across Hospitals and Traits of Fast Adopting Hospitals. Atl Econ J 45, 473–484 (2017). https://doi.org/10.1007/s11293-017-9557-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11293-017-9557-3

Keywords

JEL

Search

Navigation