Predicting effects of minimal invasive therapy

Objective: To estimate expected effects of minimal invasive therapy (MIT). 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 change on hospitals over the next 5 years. We used these responses to predict effects on hospitals of MIT. We also compared predictions against published data 2 years later. Results: Respondents predicted 34 specific operations would be performed using MIT, and that 53%;, of the patients undergoing these operations would receive MIT procedure. This transformation 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 other countries. Conclusion: Many of the trends predicted, by respondents are being borne out. If these trends continue, MIT will have profound 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 directed first to the hospital sector, given expected effects of changes of clinical service mix, revenues, and the need for different, and differently trained, personnel.