The importance of surgeons and their peers in adoption and diffusion of innovation: An observational study of laparoscopic colectomy adoption and diffusion in England. (March 2021)

• Record Type: Journal Article
• Authors: Barrenho, Eliana; Miraldo, Marisa; Propper, Carol; Walsh, Brendan
• Is Part Of: Social science & medicine. Volume 272(2021)
• Publication Date: 2021-03
• Subjects: Adoption and diffusion of innovation -- Colorectal cancer -- Networks -- Peer effects; Social medicine -- Periodicals; Medical anthropology -- Periodicals; Public health -- Periodicals; Psychology -- Periodicals; Medicine -- Periodicals; Medicine -- Periodicals; Médecine sociale -- Périodiques; Anthropologie médicale -- Périodiques; Santé publique -- Périodiques; Psychologie -- Périodiques; Médecine -- Périodiques; Electronic journals; 362.105
• DOI: 10.1016/j.socscimed.2021.113715
• Languages: English
• ISSNs: 0277-9536

Abstract

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. Highlights: Experience and peers' behaviour impacts adoption and diffusion of innovation. Network size increases adoption of laparoscopic colectomy. Hospitals play a small role in the adoption and diffusion of innovation. Connecting non-adopters to adopters of the innovation increases its diffusion.