Related Experiment Video
Updated: Feb 12, 2026
07:25
Driving Under the Influence: How Music Listening Affects Driving Behaviors
Published on: March 27, 2019
13.1K
What drives centralisation in cancer care?
Melvin J Kilsdonk1,2, Sabine Siesling1,2, Boukje A C van Dijk1,3
1Netherlands Comprehensive Cancer Organisation, dept. of research, Utrecht, the Netherlands.
Plos One
|April 13, 2018
Summary
Centralizing cancer surgery in high-volume centers improved care. Regulations and scientific evidence drove this shift for esophageal, pancreatic, and bladder cancer surgeries in the Netherlands.
Area of Science:
- Oncology
- Health Services Research
- Surgical Outcomes
Background:
- Centralization of cancer services aims to improve patient outcomes by concentrating care in high-volume centers.
- Despite evidence from the 1990s linking specialization and high surgical volumes to better outcomes, implementing centralization has been challenging globally.
- This study investigates the factors influencing the centralization of cancer services within the Netherlands.
Purpose of the Study:
- To determine the key factors driving the centralization of cancer surgery in the Netherlands.
- To analyze the timeline and impact of evidence, professional society actions, and regulations on centralization patterns.
- To understand the implementation process of specialized cancer care models.
Main Methods:
- Analysis of centralization patterns for three cancer types (esophagus, pancreas, bladder) known to benefit from high surgical caseloads.
- Utilized data from the Netherlands Cancer Registry (2000-2013) covering 8037, 4747, and 6362 surgical patients, respectively.
- Correlated timelines of centralization with the emergence of scientific evidence, medical society initiatives, and regulatory changes.
Main Results:
- A gradual increase in centralization for esophageal and pancreas cancer surgery was observed starting in 2005-2006, following international scientific evidence.
- Centralization milestones for bladder cancer surgery occurred in 2010 and 2013, preceding professional society guideline publications.
- Regulatory measures, specifically minimum volume requirements, appeared to be the most significant catalyst for centralization.
Conclusions:
- Scientific evidence linking surgical volume to patient outcomes initiated the centralization of cancer surgery in the Netherlands.
- Establishing evidence for organizational changes is crucial, but regulatory frameworks are essential for ensuring widespread adoption and implementation.
- A combination of strong evidence and supportive regulation is necessary for successful centralization of specialized cancer care.
Related Concept Videos
01:37Energy to Drive Translocation
2.9K
Mitochondrial protein import is powered by two distinct energy sources: ATP hydrolysis and electrochemical potential across the inner membrane. Newly synthesized precursors are bound by cytosolic chaperones of the Hsp70 family, which guide them to the import receptors on the mitochondrial surface. Utilizing the energy of ATP hydrolysis, Hsp70 chaperones transfer these precursors to the TOM receptors on the mitochondrial outer membrane.
Generally, polypeptides are unfolded by two distinct...
Generally, polypeptides are unfolded by two distinct...
2.9K
02:15M-Cdk Drives Transition Into Mitosis
6.6K
Checkpoints throughout the cell cycle serve as safeguards and gatekeepers, allowing the cell cycle to progress in favorable conditions and slow or halt it in problematic ones. This regulation is known as the cell cycle control system.
Cyclin-dependent kinases, or Cdks, work in concert with cyclins to control cell cycle transitions. M-Cdk, a complex of Cdk1 bound to M cyclin, is a well-known example of this coordinated control that drives the transition from the G2 to the M phase.
M cyclin...
Cyclin-dependent kinases, or Cdks, work in concert with cyclins to control cell cycle transitions. M-Cdk, a complex of Cdk1 bound to M cyclin, is a well-known example of this coordinated control that drives the transition from the G2 to the M phase.
M cyclin...
6.6K
01:21Interdisciplinary Care: The Health Care Team-I
2.8K
An interdisciplinary team includes many healthcare professionals working together and utilizing their skills, knowledge, and expertise to provide holistic and quality patient care.
Physicians
The physician's primary responsibility is to diagnose illness and direct the medical or surgical treatment of the condition. The authority to admit patients to a healthcare agency or institution and practice care within that setting is granted to physicians by the healthcare agency or institution...
Physicians
The physician's primary responsibility is to diagnose illness and direct the medical or surgical treatment of the condition. The authority to admit patients to a healthcare agency or institution and practice care within that setting is granted to physicians by the healthcare agency or institution...
2.8K
01:18Interdisciplinary Care: The Health Care Team-II
2.3K
An interdisciplinary team includes many healthcare professionals working together and utilizing their skills, knowledge, and expertise to provide holistic and quality patient care. Here are a few more healthcare professionals.
Physical Therapist
A physical therapist (PT) aims to restore function or prevent additional impairment in a patient following an injury or disease. Massage, heat, cold, water, sonar waves, exercises, and electrical stimulation are some treatments used by PTs to treat...
Physical Therapist
A physical therapist (PT) aims to restore function or prevent additional impairment in a patient following an injury or disease. Massage, heat, cold, water, sonar waves, exercises, and electrical stimulation are some treatments used by PTs to treat...
2.3K
01:25Continuing Care
2.0K
Continuing care describes the variety of health, personal, and social services provided over a prolonged period. The need for continuing care is increasing because people are living longer. Many people do not have families or others to care for them. Continuing care is mainly for patients who are disabled, functionally dependent, or suffering from a terminal disease. It is available within institutional settings or in homes. Examples include nursing centers or facilities, assisted living,...
2.0K
01:22Standards of Care I
1.2K
Federal statutes profoundly impact nursing practice, providing critical guidelines to ensure patient care is equitable, accessible, and of the highest quality. The following laws address distinct aspects of healthcare provision and patient rights:
1.2K