Minimally-Invasive Surgery Use Varies in U.S.
Variation seen with hospital type, size, location, and geographical region.
Hospital utilization of minimally invasive surgery for common procedures varies widely nationwide, according to a study published in BMJ.
Michol A. Cooper, M.D., from the Johns Hopkins University in Baltimore, and colleagues retrospectively reviewed data from the U.S. Nationwide Inpatient Sample database (2010). A propensity score model was used to calculate the predicted proportion of minimally invasive operations for each procedure at each hospital based on patient characteristics. Comparisons were made and hospitals were categorized into thirds based on the actual to predicted proportion of utilization of minimally invasive surgery.
The researchers found that mean hospital utilization of minimally invasive surgery was 71.0 percent for appendectomy, 28.4 percent for colectomy, 13.0 percent for hysterectomy, and 32.0 percent for lung lobectomy. For each procedure type, utilization of minimally invasive surgery was highly variable.
Minimally invasive surgery was linked to fewer surgical complications compared with open surgery, respectively: overall rate for appendectomy (P < 0.001); colectomy (P < 0.001); hysterectomy (P < 0.001); and lung lobectomy (P < 0.05). High utilization of minimally invasive surgery was associated with urban location (appendectomy, colectomy, hysterectomy); large hospital size (hysterectomy); teaching hospital (hysterectomy); Midwest region (appendectomy); south region (appendectomy, colectomy); and west region (appendectomy).
"Hospital utilization of minimally invasive surgery for appendectomy, colectomy, total abdominal hysterectomy, and lung lobectomy varies widely in the United States, representing a disparity in the surgical care delivered nationwide," the authors write.