The Impact of New Surgical Techniques on Geographical Unwarranted Variation
The Case of Benign Hysterectomy
Bibliographic Data
| ID | 15500225 |
|---|---|
| Authors | Daniel Adrian Lungu (0000-0002-8612-8384, Scuola Superiore Sant'Anna, corresponding author), Elisa Foresi (Scuola Superiore Sant'Anna), Paolo Belardi (0000-0002-8041-8989, Scuola Superiore Sant'Anna), Sabina Nuti (0000-0002-2093-1828, Scuola Superiore Sant'Anna), Andrea Giannini (0000-0002-4388-0082, University of Pisa), Tommaso Simoncini (0000-0002-2971-0079, University of Pisa) |
| Year | 2021 |
| Volume | 18 |
| Issue | 13 |
| Pages | 6722-6722 |
| Publication date | 2021-06-22 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | International Journal of Environmental Research and Public Health (JOURNAL) |
| Journal identifiers | ISSN: 1661-7827 • E-ISSN: 1660-4601 |
| Publisher | Multidisciplinary Digital Publishing Institute (PUBLISHER • CH) |
| DOI | 10.3390/ijerph18136722 |
| PMID | 34206452 |
| OpenAlex | W3176404839 |
| Language | EN |
| References cited | 5 |
Since the 1980s, the international literature has reported variations for healthcare services, especially for elective ones. Variations are positive if they reflect patient preferences, while if they do not, they are unwarranted, and thus avoidable. Benign hysterectomy is among the most frequent elective surgical procedures in developed countries, and, in recent years, it has been increasingly delivered through minimally invasive surgical techniques, namely laparoscopic or robotic. The question therefore arises over what the impact of these new surgical techniques on avoidable variation is. In this study we analyze the extent of unwarranted geographical variation of treatment rates and of the adoption of minimally invasive procedures for benign hysterectomy in an Italian regional healthcare system. We assess the impact of the surgical approach on the provision of benign hysterectomy, in terms of efficiency (by measuring the average length of stay) and efficacy (by measuring the post-operative complications). Geographical variation was observed among regional health districts for treatment rates and waiting times. At a provider level, we found differences for the minimally invasive approach. We found a positive and significant association between rates and the percentage of minimally invasive procedures. Providers that frequently adopt minimally invasive procedures have shorter average length of stay, and when they also perform open hysterectomies, fewer complications
Business · General surgery · Health care · Healthcare system · Hysterectomy · Invasive surgery · Laparoscopic hysterectomy · Minimally invasive procedures · Regional variation · Surgical procedures · Variation (astronomy · Endometriosis Research and Treatment · Medicine · Minimally Invasive Surgical Techniques · Uterine Myomas and Treatments · Surgery
| Citation velocity | historical |
|---|---|
| Highly cited | No |