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Can increasing levels of clinical activity really provide hospitals with a way to improve the quality and efficiency of health care?Within the NHS, purchasers and providers are under pressure to reduce management and operational costs, and to make efficiency savings. Concentrating services through trust mergers or service rationalisation has been seen by many as a way of achieving these goals.However, after systematically reviewing the international literature, researchers at the University of York question whether concentrating hospital services automatically provides these benefits.* much research over-estimates the impact of volume on the quality of care;* there is no clear link between hospitals carrying out larger volumes of surgical procedures and having better outcomes;* there is no evidence that cost savings are necessarily made by increasing hospital size above approximately 200 beds;* concentrating services may reduce access to hospital care for patients living further away, particularly those who are older and poorer;* experience shows that hospital mergers do not always result in the financial benefits that were initially anticipated.Decision makers considering concentrating services should be cautious in making assumptions about health care and financial benefits which can be derived from increasing the size of units. Such assumptions are often based more on received wisdom rather than research evidence.

WX 157 Financial administration. Business management. Cost accounting --- WX 157 Financial administration. Business management. Cost accounting --- WX 157 Financial administration. Business management. Cost accounting --- Outcome Assessment (Health Care) --- Outcome Assessment (Health Care) --- Outcome Assessment (Health Care) --- Hospital Costs --- Hospital Costs --- Hospital Costs --- Health Facility Merger --- Health Facility Merger --- Health Facility Merger --- Cost Savings --- Cost Savings --- Cost Savings --- Health Facility Size --- Health Facility Size --- Health Facility Size