Department of Economics, Stanford University, United States of America.
Department of Health Policy and Management, Columbia University Mailman School of Public Health, United States of America; National Bureau of Economic Research, United States of America.
J Health Econ. 2022 Dec;86:102672. doi: 10.1016/j.jhealeco.2022.102672. Epub 2022 Sep 14.
The adoption of health care technology is central to improving productivity in this sector. To provide new evidence on how technology affects health care markets, we focus on one area where adoption has been particularly rapid: surgery for prostate cancer. Within just eight years, robotic surgery grew to become the dominant intensive prostate cancer treatment method. Using a difference-in-differences design, we show that adopting a robot drives prostate cancer patients to the hospital. To test whether this result reflects market expansion or business stealing, we also consider market-level effects of adoption and find effects that are significant but smaller, suggesting that adoption expands the market while also reallocating some patients across hospitals. Marginal patients are relatively young and healthy, inconsistent with the concern that adoption broadens the criteria for intervention to patients who would gain little from it. We conclude by discussing implications for the social value of technology diffusion in health care markets.
采用医疗技术是提高该行业生产力的核心。为了提供关于技术如何影响医疗保健市场的新证据,我们专注于一个采用速度特别快的领域:前列腺癌手术。在短短八年时间内,机器人手术已成为主导的前列腺癌强化治疗方法。通过使用双重差分设计,我们发现采用机器人会促使前列腺癌患者前往医院。为了检验这一结果是否反映了市场扩张还是业务抢夺,我们还考虑了采用机器人的市场层面影响,发现其影响虽然显著但较小,表明采用机器人既扩大了市场,也在医院之间重新分配了一些患者。边缘患者相对年轻且健康,这与人们担心采用机器人会放宽对那些从中获益甚微的患者进行干预的标准的看法不一致。最后,我们讨论了技术在医疗保健市场中的扩散对其社会价值的影响。