Regionalisation of health services: Benefits and impact

Providing a well-integrated, cost-effective, quality health care system that meets the needs of the population is challenging for governments worldwide. In Australia, this challenge is complicated by a geographically and culturally diverse population; and complex funding and responsibilities across different levels of government. Regionalisation in health care is about enabling appropriate allocation and integration of resources according to the local population health needs, and community engagement and quality improvement to optimise delivery. From a governance perspective, control and accountability for allocation of resources and delivery of services may be centralised, decentralised, or a mixture of both. This review examines the different approaches that have been used in Australia; and assesses what is known of their effectiveness in terms of: patient health outcomes and experience, cost containment, economies of scale, accountability, citizen participation in decision-making, integration of services, and quality and equity of care. An overview of the current global trends in regionalisation is also presented.