The impact of hospital regionalisation policies on treatment costs: a systematic literature review

Abstract

This systematic literature review and meta-synthesis aimed to explore the impact of regionalisation of hospital services on healthcare costs. The authors searched PubMed, Scopus, EMBASE, EBSCO, Google Scholar, Web of Science and Cochrane Library databases to identify relevant studies, with no limits based on year of publication or country. Search terms included the key words ‘regionalisation’, ‘hospital’ and ‘cost’, along with related terms. Of the 310 identified studies, 37 were included in the final review. A meta-synthesis was carried out to assess the primary outcome measure of costs in regional hospitals, as well as the secondary outcome measures of patient mortality rates, length of stay and accessibility. A total of 28 studies suggested that regional hospitals had lower long-term costs than non-regional hospitals, largely because of the skills and experience of the clinical teams, as well as investment in specialist medical equipment. Other identified benefits were reduced length of stay and lower patient mortality rates. However, some studies indicated that regionalisation did not entirely eliminate problems relating to patient access, with implications for further study and policy considerations.