Do Robotic Surgical Systems Improve Profit Margins? A Cross-Sectional Analysis of California Hospitals

Abstract

Objective To examine the association between ownership of robotic surgical systems and hospital profit margins. Methods This study used hospital annual utilization data, annual financial data, and discharge data for year 2011 from the California Office of Statewide Health Planning & Development. We first performed bivariate analysis to compare mean profit margin by hospital and market characteristics, and to examine whether these characteristics differed between hospitals that had one or more robotic surgical systems in 2011 and those that did not. We applied the t-test and F-test to compare mean profit margin between two groups and three or more groups, respectively. We then conducted multi-level logistic regression to determine the association between ownership of robotic surgical systems and having a positive profit margin, while controlling for other hospital and market characteristics and accounting for possible correlation among hospitals located within the same market. Results The study sample included 167 California hospitals with valid financial information. Hospitals with robotic surgical systems tended to report more favorable profit margins. However, multi-level logistic regression showed that this relationship (an association, not causality) became only marginally significant (OR=6.2; P=0.053) after controlling for other hospital characteristics, such as ownership type, teaching status, bed size, and surgical volumes, and market characteristics, such as total number of robotic surgical systems owned by other hospitals in the same market area. Conclusions As robotic surgical systems become widely disseminated, hospital decision makers should carefully evaluate the financial and clinical implications before making a capital investment in this technology.

Postoperative abdominal free air: How much and when is enough? Report of two cases

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The Effect of Robot Adoption on Profit Margins

“…A more recent study by Shih et al [37] employed formal statistical analysis to investigate the relationship between robot adoption and the probability of being in a profitable position. The study examined 167 Californian hospitals in relation to whether the installation of robotic surgical systems improved the likelihood of reporting positive profit margins.…”