Table. Trends in the Use of Robotic, Laparoscopic, and Open Surgery Among Medicare Beneficiaries and Privately Insured Patients by Specific Procedures, 2010-2018.
| Procedure | Medicare beneficiaries (n = 1 668 697)a | Privately insured patients (n = 616 129)b | ||||||
|---|---|---|---|---|---|---|---|---|
| Operations per year, risk-adjusted % | Annual slope, % (95% CI)c | Fold differenced | Operations per year, risk-adjusted % | Annual slope, % (95% CI)c | Fold differenced | |||
| 2010 | 2018 | 2010 | 2018 | |||||
| Robotic | ||||||||
| All | 0.5 | 11.9 | 1.6 (1.6 to 1.6) | 22.3 | 0.3 | 9.2 | 1.0 (1.0 to 1.0) | 29.6 |
| Inguinal hernia repair | 0.3 | 1.3 | 0.2 (0.1 to 0.2) | 3.9 | 0.04 | 5.5 | 0.6 (0.6 to 0.7) | 154.5 |
| Ventral hernia repair | 0.5 | 13.8 | 1.7 (1.6 to 1.7) | 25.9 | 0.1 | 8.7 | 0.9 (0.9 to 1.0) | 90.0 |
| Colectomy | 0.4 | 11.5 | 1.6 (1.6 to 1.6) | 29.1 | 0.6 | 14.9 | 1.6 (1.5 to 1.6) | 24.8 |
| Proctectomy | 1.6 | 20.7 | 2.5 (2.4 to 2.5) | 13.2 | 2.3 | 22.7 | 2.3 (2.1 to 2.4) | 10.0 |
| Laparoscopic | ||||||||
| All | 21.4 | 22.2 | 0.03 (0.01 to 0.06) | 1.0 | 27.9 | 39.6 | 1.5 (1.4 to 1.5) | 1.4 |
| Inguinal hernia repair | 16.1 | 37.5 | 2.6 (2.5 to 2.7) | 2.3 | 28.0 | 49.3 | 2.6 (2.5 to 2.7) | 1.8 |
| Ventral hernia repair | 25.8 | 15.9 | −1.3 (−1.4 to −1.2) | 0.6 | 19.0 | 15.5 | −0.5 (−0.6 to −0.3) | 0.8 |
| Colectomy | 24.1 | 22.3 | −0.4 (−0.4 to −0.3) | 0.9 | 33.8 | 30.8 | −0.4 (−0.5 to −0.3) | 0.9 |
| Proctectomy | 3.9 | 14.8 | 1.9 (1.9 to 2.0) | 3.8 | 4.6 | 14.1 | 1.5 (1.3 to 1.6) | 3.1 |
| Open | ||||||||
| All | 78.2 | 65.9 | −1.5 (−1.5 to −1.4) | 0.8 | 71.8 | 51.0 | −2.5 (−2.5 to −2.4) | 0.7 |
| Inguinal hernia repair | 83.5 | 61.1 | −2.7 (−2.8 to −2.6) | 0.7 | 71.9 | 45.1 | −3.2 (−3.2 to −3.1) | 0.6 |
| Ventral hernia repair | 73.7 | 70.2 | −0.3 (−0.4 to −0.2) | 1.0 | 80.9 | 75.9 | −0.5 (−0.6 to −0.3) | 0.9 |
| Colectomy | 75.7 | 66.2 | −1.0 (−1.0 to −0.98) | 0.9 | 65.6 | 54.3 | −1.3 (−1.4 to −1.2) | 0.8 |
| Proctectomy | 94.7 | 64.6 | −4.3 (−4.3 to −4.2) | 0.7 | 93.1 | 63.2 | −3.7 (−3.8 to −3.5) | 0.7 |
a
For Medicare beneficiaries undergoing surgery between 2010 and 2018, data were collected from MEDPAR files.
b
For privately insured patients undergoing surgery between 2010 and 2018, data were collected from MarketScan.
c
Refers to annual increase or decrease in the proportional use of each approach by operation.
d
Fold difference was defined by dividing the proportional use of a given approach in 2018 by the proportional use in 2010.