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Comment & Response
September 2016

Do Surgeons or Does Hospital Economics Ultimately Decide Operative Approach?—Reply

Author Affiliations
  • 1Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York
  • 2Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surgeons, New York, New York
  • 3New York Presbyterian Hospital, New York
  • 4Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
  • 5Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York
JAMA Surg. 2016;151(9):884. doi:10.1001/jamasurg.2016.0835

In Reply We appreciate the interest of Matulewicz and Meeks in our work. The objective of our analysis was to examine the association between regional market competition and hospital financial status regarding 5 common urologic and gynecologic procedures. For all of the procedures, we noted a strong association between increased market competition and the performance of robotic-assisted surgery. Importantly, we did not analyze the effectiveness of these procedures but sought only to explore potential nonmedical factors that drove the diffusion of the interventions.

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