Evidence map›Paper›PMID 42265731›Full record

SynthesisBMC health services research2026

Development of a core outcome set for studies on centralization of healthcare services.

Stefanie Pfisterer-Heise, Julia Scharfe, Alexander Pachanov, Charlotte Mareike Kugler, Eni Shehu, Tim Mathes, René Mantke, Dawid Pieper

Abstract readSystematic Review
In one paragraph

Synthesis in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Stefanie Pfisterer-HeiseInstitute for Health Services and Health System Research, Center for Health Services Research Brandenburg, Brandenburg Medical School Theodor Fontane (MHB), Faculty of Health Sciences Brandenburg, Rüdersdorf bei Berlin, Germany. stefanie.heise@mhb-fontane.de.
Julia ScharfeInstitute for Health Services and Health System Research, Center for Health Services Research Brandenburg, Brandenburg Medical School Theodor Fontane (MHB), Faculty of Health Sciences Brandenburg, Rüdersdorf bei Berlin, Germany.
Alexander PachanovInstitute for Health Services and Health System Research, Center for Health Services Research Brandenburg, Brandenburg Medical School Theodor Fontane (MHB), Faculty of Health Sciences Brandenburg, Rüdersdorf bei Berlin, Germany.
Charlotte Mareike KuglerInstitute for Health Services and Health System Research, Center for Health Services Research Brandenburg, Brandenburg Medical School Theodor Fontane (MHB), Faculty of Health Sciences Brandenburg, Rüdersdorf bei Berlin, Germany.
Eni ShehuInstitute for Health Services and Health System Research, Center for Health Services Research Brandenburg, Brandenburg Medical School Theodor Fontane (MHB), Faculty of Health Sciences Brandenburg, Rüdersdorf bei Berlin, Germany.
Tim MathesDepartment of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany.
René MantkeClinic for General and Visceral Surgery, University Hospital Brandenburg, Brandenburg an der Havel, Germany.
Dawid PieperInstitute for Health Services and Health System Research, Center for Health Services Research Brandenburg, Brandenburg Medical School Theodor Fontane (MHB), Faculty of Health Sciences Brandenburg, Rüdersdorf bei Berlin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCentralization defined as the reorganization of healthcare services into fewer specialized units serving a higher volume of patients is a strategy to improve the outcome quality of medical procedures. Studies on centralization, however, tend to measure and report different outcomes impeding evidence syntheses. To advance research on the effects of centralization, this study aimed at developing a core outcome set (COS) for studies on centralization of hospital procedures. The envisaged COS should be generic and include all relevant outcomes irrespective of available data or measurement instruments.

methodsFor developing the COS, we conducted (1) a systematic review on the effects of minimum volume standards in hospitals, (2) a focus group study with patient representatives, (3) two interview studies with representatives of medical societies and statutory health insurance funds, (4) an online study with health services researchers, (5) the development of a longlist of outcomes and (6) a two-round Delphi study with all aforementioned participants. All interest-holder groups were based in Germany. The collected outcomes were categorized according to the Cochrane Effective Practice and Organisation of Care (EPOC) outcome taxonomy. A priori, we defined to include an outcome if ≥75% of all participants in a respective interest-holder group rated an outcome with 7-9 (critically important) on a 9-point Likert scale, and if this criterion was met by at least two interest-holder groups.

resultsIn total, 61 participants took part in the focus groups (n = 14), the interviews (n = 28) and the online survey (n = 19). Of these 36 and 34 participated in Delphi I and II, respectively. From the studies, 48 outcomes were derived and presented in Delphi I. Based on participants' comments 45 outcomes were displayed in the Delphi II survey. The final COS comprises 27 outcomes in all EPOC outcome domains. Nine of these belong to the EPOC outcome domain "Outcomes related to the quality of care".

conclusionsFuture studies on centralization should measure and report outcomes from a broad range of outcome domains, including outcomes in the domain "Quality of care". Instruments for measuring these outcomes need to be consented.

Indexed as

Centralized Hospital ServicesOutcome Assessment, Health CareDelphi TechniqueFocus GroupsGermanyHealth Services ResearchHumansCentralisationCentralizationCore outcome setEvidence synthesisHealth policyMinimum volume standardRegionalisationRegionalizationVolume-outcome relationship

Identifiers

PMID42265731
PMCPMC13255221

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.