Efficiency and Productivity Gains of Robotic Surgery : The Case of the English National Health Service

This paper examines the effect of new medical technology (robotic surgery) on efficiency gains and productivity changes for surgical treatment in patients with prostate cancer. We consider three interrelated surgical technologies within the English National Health System: robotic, laparoscopic and open radical prostatectomy. We do observe growing volumes of prostatectomies, mostly driven by an increase in robotic-assisted surgeries. Using data from Hospital Episodes Statistics for the period 2000-2018, we analyse whether hospital providers that adopted a robot present improved measures of throughput and quantify changes in total factor and labour productivity. We find evidence of a 33% reduction in length of stay and 40% decrease in postoperative visits to the urologist. The robotic technique increased total production at the hospital level between 22% and 36%, coupled with a 50% improvement in labour productivity. These benefits lend some, but not overwhelming, support for the large-scale hospital investments in such costly technology