Recent Study Shows Under-Utilization of Minimally Invasive Surgery in the U.S.
Tue Mar 29 13:00:27 CDT 2016
Johns Hopkins researchers report the under-utilization of MIS by hospitals in the U.S., despite strong evidence regarding advantages of a MIS approach in many common procedures.
In a British Medical Journal article published online July 8th, authors cite data from the Agency for Healthcare and Research Quality (AHRQ), re-establishing the significant reductions in surgical complications associated with MIS vs. open surgery. They also reference several Cochrane reviews of randomized control studies comparing laparoscopic surgery vs. open for appendectomy, colectomy, hysterectomy and lung lobectomy surgeries, which demonstrate consistent superior patient outcomes associated with MIS.
The researchers further analyzed 2010 AHRQ data looking for commonalities among hospitals which are high adopters of MIS surgery and among those which are medium or low adopters.
What they found indicated that the percent adoption of MIS was not closely associated with factors such as hospital bed size, urban vs. rural, or teaching vs. non-teaching hospitals as might have been expected. They concluded that although MIS is associated with significantly better outcomes, the choice of surgery is often discretionary and based on surgeon preference, resulting in an element of randomness in terms of quality of care.
The authors suggest that increased standardization of surgeon training on MIS for surgical residents and fellows would be a key factor in reducing the disparity of care they observed. The article also goes on to suggest that given the strong association of MIS with improved outcomes, a hospital’s percentage of MIS utilization should be considered as a transparent quality measure to encourage adoption of demonstrated best surgical practices.