PREDICTING EFFECTS OF MINIMAL INVASIVE THERAPY

Objective: To estimate expected effects of minimal invasive therapy (M IT). Design: We developed a structured questionnaire and sent it to 35 mainly senior academic surgeons considered leaders in MIT in the UK, USA, and Canada. We asked their opinions on which specific operations would be done by minimal invasive technique and the effects of this ch ange on hospitals over the next 5 years. We used these responses to pr edict effects on hospitals of MIT. We also compared predictions agains t published data 2 years later. Results: Respondents predicted 34 spec ific operations would be performed using MIT, and that 53%;, of the pa tients undergoing these operations would receive MIT procedure. This t ransformation would lead, in their opinion, to a decline of 10 million inpatient hospital days, a 62% decline of average length of stay for operations predicted amenable to MIT, and a resultant savings of $4.5 billion in the U.S. Comparable effects could be expected to occur in o ther countries. Conclusion: Many of the trends predicted, by responden ts are being borne out. If these trends continue, MIT will have profou nd effects on patients (clinical, quality of life function), providers (hospital utilization and financing, physician training), and payers (expenditures) in all countries if respondents' predictions about MIT and its impact are even reasonably accurate. Attention should be direc ted first to the hospital sector, given expected effects of changes of clinical service mix, revenues, and the need for different, and diffe rently trained, personnel.