The importance of surgeons and their peers in adoption and diffusion of innovation: an observational study of laparoscopic colectomy adoption and diffusion in England
File(s)
Accepted version
Author(s)
Barrenho, Eliana
Miraldo, Marisa
Propper, Carol
Walsh, Brendan
Type
Journal Article
Abstract
Little is known about the role of clinicians in accounting for adoption and diffusion of medical innovations, especially within the English National Health System. This study examines the importance of surgical consultants and their work-based networks on the diffusion of an important innovation, minimally invasive elective laparoscopic colectomy for colorectal cancer. The study used linked patient-level and workforce data on 260,110 elective colectomies and 1288 consultants between 2000 and 2014, to examine adoption of laparoscopic colectomy pre- and post-introduction of clinical guidelines and total share of colectomies performed laparoscopically by adopters. Laparoscopy as a share of elective colectomy increased from 0% in 2000 to 53% in 2014. Surgeons, rather than hospitals, were the principal agents accounting for the increase and explain 46.6% of the variance in laparoscopic colectomy use. Female surgeons, surgeons trained outside the United Kingdom, and recent graduates had higher rates of laparoscopy adoption. More experienced surgeons and surgeons with more peers who perform laparoscopy were more likely to adopt, adopt early and have greater use of laparoscopy. Targeting clinicians, rather than hospitals, is central to increasing adoption and diffusion of new medical technologies.
Date Issued
2021-03-01
Date Acceptance
2021-01-21
Citation
Social Science and Medicine, 2021, 272
ISSN
0277-9536
Publisher
Elsevier
Journal / Book Title
Social Science and Medicine
Volume
272
Copyright Statement
© 2021 Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/
Sponsor
The Health Foundation
Commission of the European Communities
Grant Number
7422
788529
Subjects
Adoption and diffusion of innovation
Colorectal cancer
Networks
Peer effects
11 Medical and Health Sciences
14 Economics
16 Studies in Human Society
Public Health
Publication Status
Published
Article Number
ARTN 113715
Date Publish Online
2021-01-28