A review of how centralization policies affect high-risk surgeries
Journal
Taiwan Journal of Public Health
Journal Volume
35
Journal Issue
4
Pages
376-390
Date Issued
2016
Author(s)
Abstract
A great deal of evidence from volume-outcome studies has indicated that surgical volume is negatively associated with adverse surgery outcomes; therefore, researchers and policymakers in many countries have advocated for the Centralization of certain surgical procedures. Centralization should improve outcomes and increase the level of care by ensuring that patients are referred to high-quality providers. This article reviews (1) the development of centralization policies and (2) centralization strategies applied in the United States, Canada, and countries in Europe and Asia. We also discuss the impacts that centralization policies have had on surgery outcomes as well as implications for the future of centralization policies in Taiwan. The vast majority of centralization policies focus on rare or high-risk surgeries, such as those performed to treat heart problems or cancer. There are currently two types of intervention: setting minimum volume standards and selecting designated referral centers. A review of relevant literature showed that, for most countries, centralization policies led to better healthcare outcomes; however, some studies noted that centralization can reduce accessibility to care. Nonetheless, we suggest that Taiwan consider adopting centralization as a policy to improve the quality of healthcare. However, future research will be required to estimate the effectiveness of centralization on high-risk surgeries.
Subjects
Centralization; Quality of healthcare; Regionalization; Volume-outcome studies
SDGs
Other Subjects
Canada; cancer susceptibility; centralization; Europe; heart; human; patient referral; regionalization; scientist; surgery; surgical technique; Taiwan; United States
Type
journal article