Concept review of regionalized systems of acute care: Is regionalization the next frontier in sepsis care?

Abstract

Regionalization has become a buzzword in US health care policy. Regionalization, however, has varied meanings, and definitions have lacked contextual information important to understanding its role in improving care. This concept review is a comprehensive primer and summation of 8 common core components of the national models of regionalization informed by text-based analysis of the writing of involved organizations (professional, regulatory, and research) guided by semistructured interviews with organizational leaders. Further, this generalized model of regionalized care is applied to sepsis care, a novel discussion, drawing on existing small-scale applications. This discussion highlights the fit of regionalization principles to the sepsis care model and the actualized and perceived potential benefits. The principal aim of this concept review is to outline regionalization in the United States and provide a roadmap and novel discussion of regionalized care integration for sepsis care.

Keywords: delivery of health care; emergency service; hospital planning; integrated; intensive care units; regional medical programs; sepsis.

FIGURE 1

Flow diagram illustrating the standard sequencing of patient care for time‐critical conditions

FIGURE 2

Pictorial representation of the structural generalization of regionalized systems of acute care. The interior of the figure is composed of the identified 8 core components of regionalized systems that function concurrently. The circles in the outer triangle are the 3 constituents and description of the role and structure they provide relative to one another (the text on the lines between the circles) in systems of care. The figure demonstrates the multipart and party efforts that sustain the national models of regionalized care

FIGURE 3

These 3 characteristic models, which have been discussed in the literature, demonstrate the degree of integration and organization within regionalized networks of care. Arrows indicate patient flow. The “integrated web” model has emerged as the desired conception of a regionalized and integrated system of care