The institutional impact of robotic surgery adoption: evidence from prostate and thyroid cancers in South Korea

Abstract

The adoption of robotic surgery has significantly impacted various levels of the health system. However, previous studies lack evidence of causality regarding the impact at the institutional level. This study explores the effects of robotic surgery adoption on prostate and thyroid cancer treatments in South Korea, using the National Health Insurance Service (NHIS) data from 2005 to 2017. We applied interrupted time series analysis (ITSA) to examine changes in the number of inpatient admissions and volume of surgery at institutions before and after robotic surgery adoption. For prostate cancer, robotic surgery adoption resulted in an immediate increase of approximately 4.9 surgeries per quarter, with a substantial rise in inpatient admissions. For thyroid cancer, inpatient admissions showed a significant upward trend post-adoption. The increase in service volumes after the adoption of robotic surgery may reflect strategic institutional efforts to expand service delivery, supplier-induced demand to meet performance targets, or the advertising effects of robotic surgery adoption, which likely attracted patients from surrounding areas. This study highlights the broader implications of high-cost medical technologies on healthcare delivery, institutional strategies, and potential increases in healthcare costs. Future research should investigate other conditions treated with robotic surgery to fully understand its system-wide effects.