| The costs of centralisation: a systematic review of the economic impact of the centralisation of cancer services. | |
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MedLine Citation:
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PMID: 22229484 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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KE K.M., HOLLINGWORTH W. & NESS A.R. (2012) European Journal of Cancer Care The costs of centralisation: a systematic review of the economic impact of the centralisation of cancer services While evidence suggests that within specific cancer sites centralisation of services improves outcomes and quality of care, the economic impact of centralisation is unclear. This systematic review identified 19 studies that have investigated whether or not the centralisation of cancer services results in economies of scale, or is cost-effective, or increases the costs of accessing care for patients and their carers. Evidence from 13 studies suggests that increasing surgeon volumes are associated with cost reductions, although one study suggested that this relationship is U-shaped and the evidence is not consistent for hospital volumes and costs. Only one study demonstrated that centralisation was cost-effective with an incremental cost utility ratio of $5029 (€3616) per quality-adjusted life year gained. Consistent evidence from four studies suggested that centralised services increase the costs of accessing care for patients and their carers. Current evidence on the economic impact of centralisation of cancer services is limited and of poor quality. Therefore, it remains unclear whether centralisation results in economies of scale and is cost-effective. Future research should be based on a clear definition of the different components of centralisation in order to determine which aspects of centralisation are efficient and for which cancer subgroups. |
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Authors:
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K M Ke; W Hollingworth; A R Ness |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-1-9 |
Journal Detail:
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Title: European journal of cancer care Volume: - ISSN: 1365-2354 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-1-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9301979 Medline TA: Eur J Cancer Care (Engl) Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2012 Blackwell Publishing Ltd. |
Affiliation:
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LECTURER IN HEALTH ECONOMICS, School of Oral and Dental Sciences, University of Bristol, Bristol READER IN HEALTH ECONOMICS, School of Social and Community Medicine, University of Bristol, Bristol PROFESSOR OF EPIDEMIOLOGY, School of Oral and Dental Sciences, University of Bristol, Bristol, UK. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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