Centralisation of specialised healthcare services: a scoping review of definitions, types, and impact on outcomes

Ramsay AIG, Tomini SM, Gandhi S, Fulop NJ, Morris S
Record ID 32018014417
English
Authors' objectives: Centralising specialised healthcare services into high-volume centres is proposed to improve patient outcomes and efficiency. Most reviews focus on relatively few conditions and a limited range of outcomes. To review the evidence on centralisation of a range of specialised acute services, to analyse (1) how centralisations are defined; (2) how centralisations are organised and delivered; and (3) the relationship between centralisation and several key outcomes.
Authors' results and conclusions: Centralisation is commonly associated with improved care and outcomes. However, research seldom describes centralised services in sufficient detail, rarely compares different service models and tends to focus on a narrow range of outcomes. Therefore, understanding the extent and nature of centralisation’s impact – and the mechanisms by which it is achieved – remains elusive. By addressing these gaps, future research may of greater use to all stakeholders with an interest in centralisation.
Authors' methods: Scoping review, conducted in November 2020. Specialised acute healthcare services. This review was conducted in November 2020 and did not include grey literature or studies that did not analyse outcomes, so more recent and further evidence – for example, on types of centralisation model and how centralisation was implemented – may exist. As this was a scoping review, we did not conduct a quality assessment, which may reduce the confidence with which we may view the presented impacts of centralisation.
Authors' identified further research: Should provide clearer descriptions of centralisations, compare different centralisation models and study a wider range of important outcomes, including patient experience and cost-effectiveness.
Details
Project Status: Completed
URL for project: https://www.journalslibrary.nihr.ac.uk/programmes/hsdr/NIHR136250
Year Published: 2025
URL for published report: https://www.journalslibrary.nihr.ac.uk/hsdr/published-articles/REMD6648
URL for additional information: English
English language abstract: An English language summary is available
Publication Type: Full HTA
Country: England, United Kingdom
DOI: 10.3310/REMD6648
MeSH Terms
  • Delivery of Health Care
  • Delivery of Health Care, Integrated
  • Health Services Accessibility
  • Centralized Hospital Services
Contact
Organisation Name: NIHR Health Services and Delivery Research programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name: journals.library@nihr.ac.uk
Contact Email: journals.library@nihr.ac.uk
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.