Contract architecture and time-to-first public activation of robotic urology programs in Poland: a nationwide...

Public announcements of robot purchases are often treated as equivalent to new robotic-urology capacity, although procurement disclosure and stable public activity are different milestones. We assessed whether contract architecture helps interpret public activation of robotic urology programs in Poland. We conducted a nationwide open-data linkage study linking the CEZ/NFZ provider-level reimbursement workbook for robotic surgery in Poland (April 2022-June 2025) with auditable Polish da Vinci disclosures (February 2024-March 2026), an exact-PDF subset, and a fixed public Synektik page naming 42 hospitals. First public reimbursement was treated as a proxy for first publicly visible activation. Analyses included segmented diffusion modelling, rolling-origin validation, trajectory clustering, and exploratory contract-architecture clustering. Poland had 56 providers with any public robotic surgery and 53 with public RARP across 14 regions. Median first-month public RARP volume was 6 cases and median first-6-month volume was 54. A segmented Poisson model outperformed a single-trend model (AIC 119.6 vs. 138.1), with the best breakpoint in November 2022 and 24.3% lower rolling-origin predictive deviance. Among 12 urology-linked disclosures, 7 of 11 capital acquisitions occurred at active public RARP sites, 4 were likely de novo public entries, and 1 was a maintenance event. In the exact-PDF subset (n = 8), contract phenotype did not separate likely de novo from already active sites. In a mature public robotic-urology market, procurement notices more often signalled scaling or continuity within the public reimbursement layer than first public activation. Contract data became informative only after linkage to downstream public activity.