A hospital's regional competition may influence whether the hospital acquires a surgical robot, according to a new study in JAMA Surgery that suggests patients receiving treatment at hospitals in competitive regional markets are more likely to undergo robotic-assisted surgery.
Researchers analyzed more than 221,000 patients who underwent a robotic-assisted surgery for five procedures at 1,370 hospitals from 2010 to 2011 to examine an association between hospital competition, hospital financial status and the performance of robotic-assisted surgery.
They found for all five types of surgery — radical prostatectomy, total nephrectomy, partial nephrectomy, hysterectomy and oophorectomy — increased market competition was associated with an increased use of robotic-assisted surgery.
However, the researchers found hospital financial status has a limited association with using robotic-assisted surgery.
"These data imply that regional competition may influence a hospital's decision to acquire a surgical robot, but once the device is in place, market competition exerts less influence on actual within-hospital use," according to the authors.
They write that acquiring robots is a type of "medical arms race" where "hospitals in competitive market environments are…faced with the challenge of whether to offer a service of questionable value or potentially lose marketshare to competitors who choose to offer the service."
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