Diffusion of Minimally Invasive Procedures across Hospitals and Traits of Fast Adopting Hospitals

The quality and cost of hospital care depends not only on what technologies have been developed, but on how quickly the most promising and cost-effective technologies diffuse across hospitals. Some technologies are high-cost when they are first introduced into the health care system, but improve in cost-effectiveness as doctors use the technologies and innovate. Some such examples are minimally invasive procedures, which have become more common in recent years. We sought to better understand what hospital characteristics are associated with fast adoption of four minimally invasive procedures (appendectomy, lobectomy, hysterectomy and colectomy). Our findings show that a hospital’s adoption of minimally invasive procedures in one type of procedure (e.g., lobectomy) is not predictive of that hospital’s probability of adopting minimally invasive procedures in another procedure type (e.g., zero appendectomies). The only hospital characteristic consistently correlated with adoption for three of the four procedure types was the extent that the hospital’s geographic neighbors had adopted minimally invasive technology for that particular procedure. These findings regarding peer effects fall in line with conclusions about diffusion from the development literature.