Hospital robotic use for colorectal cancer care
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ORIGINAL ARTICLE
Hospital robotic use for colorectal cancer care Aaron C. Spaulding1,2 · Hanadi Hamadi3 · Osayande Osagiede4 · Riccardo Lemini2,5 · Jordan J. Cochuyt1 · John Watson5 · James M. Naessens2,6 · Dorin T. Colibaseanu2,5 Received: 24 April 2020 / Accepted: 27 August 2020 © Springer-Verlag London Ltd., part of Springer Nature 2020
Abstract The use of robotic surgery for colorectal cancer continues to increase. However, not all organizations offer patients the option of robotic intervention. This study seeks to understand organizational characteristics associated with the utilization of robotic surgery for colorectal cancer. We conducted a retrospective study of hospitals identified in the United States, State of Florida Inpatient Discharge Dataset, and linked data for those hospitals with the American Hospital Association Survey, Area Health Resource File and the Health Community Health Assessment Resource Tool Set. The study population included all robotic surgeries for colorectal cancer patients in 159 hospitals from 2013 to 2015. Logistic regressions identifying organizational, community, and combined community and organizational variables were utilized to determine associations. Results indicate that neither hospital competition nor disease burden in the community was associated with increased odds of robotic surgery use. However, per capita income (OR 1.07 95% CI 1.02, 1.12), average total margin (OR 1.01, 95% CI 1.001, 1.02) and large-sized hospitals compared to small hospitals (OR: 5.26, 95% CI 1.13, 24.44) were associated with increased odds of robotic use. This study found that market conditions within the U.S. State of Florida are not primary drivers of hospital use of robotic surgery. The ability for the population to pay for such services, and the hospital resources available to absorb the expense of purchasing the required equipment, appear to be more influential. Keywords Colorectal cancer · Robotic surgery · Hospital characteristics · Community characteristics · Market conditions
Introduction An increasing trend in the use of minimally invasive surgery (MIS) has been observed in the United States since the early 1990s [1]. There are two modalities for conducting * Aaron C. Spaulding [email protected] 1
Department of Health Sciences Research, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL 32224, USA
2
Robert D. and Patricia E. Kern Center for Science of Health Care Delivery, Jacksonville, FL, USA
3
Department of Health Administration, Brooks College of Health, University of North Florida, Jacksonville, FL, USA
4
Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, New York, NY, USA
5
Division of Colon and Rectal Surgery, Mayo Clinic, Jacksonville, FL, USA
6
Department of Health Sciences Research, Mayo Clinic, Jacksonville, Rochester, MN, USA
MIS, the first is advanced robotic systems, and the second is non-robotic or laparoscopic surgery. Non-robotic MIS has been supported through numerous academic studies and is a common e
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