Published: 15 August 2019

Regional health organisations. An evidence review

Regional health organisations have been implemented in health systems throughout the world as a means of ensuring that health services meet local needs. The aim of this evidence review was to investigate the impact of introducing a regionalised healthcare system and to determine the key barriers to and facilitators of the implementation of regionalisation. 

We conducted two systematic reviews; the first assessed the impact of regionalisation and the second examined the barriers to and facilitators of regionalisation. We included 33 articles for the systematic review on impact; these articles reported on outcomes such as utilisation of resources, cost, equity, health and care outcomes, and efficiency. The impact of regionalisation on specific outcomes was highly dependent on country context. The second systematic review on barriers to and facilitators of implementation of regionalisation included 27 studies. Three thematic areas were identified across the included studies: influence of central government on regionalisation, balancing competing interests between central government and regional health organisations, and processes and procedures within regional health organisations.

We found some evidence to suggest that a regionalised healthcare system could ultimately lead to a healthy population and an efficient health system. However, policymakers need to consider important barriers to and facilitators of effective implementation. Moreover, the implementation of regional health organisations involves a vast array of interconnected elements, which should be reflected in the design of a national monitoring and evaluation framework. Regionalisation is a complex process, for which outcomes are neither straightforward nor predictable, but dependent on a country’s socioeconomic, institutional, and cultural context.


  • Joan Quigley
  • Camille Coyle
  • Claire O'Dwyer
  • Gerald O'Nolan
  • Louise Farragher
  • Jean Long

Publication (PDF, 2 MB)

Publication (PDF, 2 MB)

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