Raymond N. KuoKUO-PIAO CHUNG2018-09-102018-09-102016http://www.scopus.com/inward/record.url?eid=2-s2.0-85007284605&partnerID=MN8TOARShttp://scholars.lib.ntu.edu.tw/handle/123456789/397729A 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.Centralization; Quality of healthcare; Regionalization; Volume-outcome studies[SDGs]SDG3Canada; cancer susceptibility; centralization; Europe; heart; human; patient referral; regionalization; scientist; surgery; surgical technique; Taiwan; United Statesjournal article10.6288/TJPH201635105016