Medical College of Wisconsin
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The association of robotic surgical technology and hospital prostatectomy volumes: increasing market share through the adoption of technology. Cancer 2012 Jan 15;118(2):371-7

Date

07/01/2011

Pubmed ID

21717434

DOI

10.1002/cncr.26271

Scopus ID

2-s2.0-84855483445   30 Citations

Abstract

BACKGROUND: Despite limited and conflicting evidence for the efficacy of newly developed robotic technology for laparoscopic prostatectomy, this technology is spreading rapidly. Because the newer technology is more costly, reasons for this rapid adoption are unclear. The authors of this report sought to determine whether hospital acquisition of robotic technology was associated with volume of prostate cancer surgery.

METHODS: The inpatient dataset of claims records from 2002 to 2008 and the acquisition dates of robotic technology were used to examine the rates of prostatectomy in Wisconsin hospitals. In analyses that accounted for hospital and referral region characteristics, changes in hospital prostatectomy volume were examined for their association with technology acquisition. Overall trends in the rate of prostatectomy also were examined over the study period.

RESULTS: In total, 10,021 prostatectomies were performed in 52 hospitals in Wisconsin's 8 health referral regions during the study period. The mean quarterly prostatectomy volume in hospitals that did not acquire the technology was 4.5 in 2002 and 3.1 in 2007/2008. In contrast, the mean quarterly prostatectomy volume in hospitals that went on to acquire robotic technology was 16.5 in 2002 and 24.8 in 2007/2008. In adjusted models, the acquisition of a robot was associated with a 114% annual increase (95% confidence interval, 62%-177% annual increase) in hospital prostatectomy volume. The average Wisconsin hospital prostatectomy volume was unchanged during 2002 through 2006 but increased by 25.6% in 2007.

CONCLUSIONS: Robotic technology acquisition occurred rapidly in Wisconsin hospitals, and hospitals that acquired a robot had large increases in prostatectomy volume.

Author List

Neuner JM, See WA, Pezzin LE, Tarima S, Nattinger AB

Authors

Ann B. Nattinger MD, MPH Associate Provost, Professor in the Medicine department at Medical College of Wisconsin
Joan Neuner MD, MPH Professor in the Medicine department at Medical College of Wisconsin
Liliana Pezzin PhD, JD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
William A. See MD Chair, Professor in the Urologic Surgery department at Medical College of Wisconsin
Sergey S. Tarima PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Biomedical Technology
Humans
Male
Prostatectomy
Prostatic Neoplasms
Robotics
Surgery Department, Hospital
Treatment Outcome
Wisconsin
jenkins-FCD Prod-480 9a4deaf152b0b06dd18151814fff2e18f6c05280