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

Author

Listed:
  • Maynou, Laia
  • Pearson, Georgia
  • McGuire, Alistair
  • Serra-Sastre, Victoria

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.

Suggested Citation

  • Maynou, Laia & Pearson, Georgia & McGuire, Alistair & Serra-Sastre, Victoria, 2022. "The diffusion of robotic surgery: examining technology use in the English NHS," LSE Research Online Documents on Economics 114535, London School of Economics and Political Science, LSE Library.
  • Handle: RePEc:ehl:lserod:114535
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    File URL: http://eprints.lse.ac.uk/114535/
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    References listed on IDEAS

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    1. Dranove, David & Garthwaite, Craig & Li, Bingyang & Ody, Christopher, 2015. "Investment subsidies and the adoption of electronic medical records in hospitals," Journal of Health Economics, Elsevier, vol. 44(C), pages 309-319.
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    Cited by:

    1. Tafti, Elena Ashtari, 2023. "Technology, Skills, and Performance: The Case of Robots in Surgery," CINCH Working Paper Series (since 2020) 78746, Duisburg-Essen University Library, DuEPublico.
    2. Maynou, Laia & McGuire, Alistair & Serra-Sastre, Victoria, 2024. "What happens when the tasks dry up? Exploring the impact of medical technology on workforce planning," LSE Research Online Documents on Economics 124065, London School of Economics and Political Science, LSE Library.
    3. Laia Maynou & Alistair McGuire & Victoria Serra‐Sastre, 2024. "Efficiency and productivity gains of robotic surgery: The case of the English National Health Service," Health Economics, John Wiley & Sons, Ltd., vol. 33(8), pages 1831-1856, August.
    4. Elena Ashtari Tafti, 2022. "Technology, skills, and performance: the case of robots in surgery," IFS Working Papers W22/46, Institute for Fiscal Studies.

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    More about this item

    Keywords

    adoption; diffusion; robotic surgery; substitution; technology;
    All these keywords.

    JEL classification:

    • O33 - Economic Development, Innovation, Technological Change, and Growth - - Innovation; Research and Development; Technological Change; Intellectual Property Rights - - - Technological Change: Choices and Consequences; Diffusion Processes
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • C41 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods: Special Topics - - - Duration Analysis; Optimal Timing Strategies
    • C33 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Models with Panel Data; Spatio-temporal Models
    • J20 - Labor and Demographic Economics - - Demand and Supply of Labor - - - General

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