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Regionalization for health improvement: A systematic review
Maíra Catharina Ramos1,2, Jorge Otávio Maia Barreto2, Helena Eri Shimizu1
1Faculty of Health Sciences, University of Brasilia, Brasília, Brazil.
Plos One
|December 22, 2020
Summary
Healthcare regionalization improves care quality and resource use. Concentrating procedures in high-volume hospitals effectively reduces hospital stays and mortality rates.
Area of Science:
- Health Services Research
- Healthcare Management
- Public Health Policy
Background:
- Regionalization integrates healthcare systems for better care quality and resource allocation.
- Many countries adopt regionalization strategies to optimize health service delivery.
- Effective interventions for regionalization require systematic evaluation.
Purpose of the Study:
- To systematically review interventions enhancing health and management indicators in regionalized healthcare systems.
- To identify effective strategies for improving health services regionalization.
- To assess the impact of regionalization on healthcare quality and resource utilization.
Main Methods:
- Systematic literature search in relevant databases (updated Oct 2020).
- Inclusion of experimental and observational studies on regionalization interventions.
- Methodological assessment using Joanna Briggs Institute tools and GRADE for outcomes.
Main Results:
- Sixteen interventions were identified for improving health system regionalization management.
- Regionalization proved effective with administrative decentralization and resource rationalization.
- Concentrating procedures in high-volume hospitals reduced hospitalization days and in-hospital mortality.
Conclusions:
- Regionalization, particularly with administrative decentralization, enhances resource rationalization and healthcare management.
- Strategies like procedure centralization in high-volume centers yield positive outcomes.
- Implementing regionalization necessitates adapting health practice standards and resource distribution, especially for specialized services.
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