439 THE ASSOCIATION BETWEEN DIFFUSION OF THE SURGICAL ROBOT AND RADICAL PROSTATECTOMY RATES

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Cost Effectiveness1 Apr 2011439 THE ASSOCIATION BETWEEN DIFFUSION OF THE SURGICAL ROBOT AND RADICAL PROSTATECTOMY RATES Danil Makarov, James Yu, Rani Desai, David Penson, and Cary Gross Danil MakarovDanil Makarov New York, NY , James YuJames Yu New Haven, CT , Rani DesaiRani Desai West Haven, CT , David PensonDavid Penson Nashville, TN , and Cary GrossCary Gross New Haven, CT View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.530AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Despite its expense and controversy surrounding its benefit, the surgical robot has been widely adopted for the treatment of prostate cancer. We sought to determine the relationship between surgical robot acquisition and changes in volume of radical prostatectomy (RP) at the regional and hospital levels. METHODS We performed a retrospective cohort study examining men undergoing RP for prostate cancer at non-federal, community hospitals located in the states of AZ, FL, MD, NC, NY, NJ, and WA. We measured change in number of RPs at the regional and hospital levels before (2001) and after (2005) dissemination of the surgical robot. RESULTS Combining data from the Healthcare Cost and Utilization Project State Inpatient Databases 2001 and 2005 with the 2005 American Hospital Association Survey and publicly available data on robot acquisition, we identified 554 hospitals in 71 hospital referral regions (HRR). The total RPs decreased from 14,801 to 14,420 during the study period. Thirty six (51%) HRRs had at least one hospital with a surgical robot by 2005; 67 (12%) hospitals acquired surgical robots. Adjusted, clustered Generalized Estimating Equations (GEE) analysis demonstrated HRRs with greater numbers of hospitals acquiring robots had higher increases in RPs than HRRs acquiring none (mean changes in RPs for HRRs with 9,4,3,2,1,0 are 414.9, 189.6,106.6,14.7,−11.3,−41.2, p<0.0001). Hospitals acquiring surgical robots increased RPs by a mean of 29.1/year while those without robots experienced a mean change of –4.8, p<0.0001. CONCLUSIONS Surgical robot acquisition is associated with increased numbers of RPs at the regional and hospital levels. Policy makers must recognize the intimate between technology diffusion and procedure utilization when approving costly new medical devices with unproven benefit. Download PPT © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e178-e179 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Metrics Author Information Danil Makarov New York, NY More articles by this author James Yu New Haven, CT More articles by this author Rani Desai West Haven, CT More articles by this author David Penson Nashville, TN More articles by this author Cary Gross New Haven, CT More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...