Centralization and the Accreditation Process: A Mutual Relationship

In the previous chapters of this book, some of the world-wide experts on different fields of surgical oncology dealt with the significance of the volume-outcome relationship, highlighting what is good and what is less good in such a union. While some conclusions are data-driven and straightforward, others are extrapolated and more complicated to translate into clinical practice. As previously mentioned, in the context of different health systems worldwide, such as national health systems and private insurances, there are different stakeholders that express different needs: politicians, patients, surgeons, institutions and medical associations do not have always the same needs. From the case-studies of reimbursements for hepato-biliary-pancreatic surgery and colorectal surgery, this last chapter will focus on some important issues including the accreditation process, suggesting some practical proposals that hopefully will serve as a constructive action plan.