Reply: Embracing regionalization worldwide

Dr Backer is a consultant for W. L. Gore & Associates, Inc.The Journal policy requires editors and reviewers to disclose conflicts of interest decline handling or reviewing manuscripts which they may have conflict interest. The this article no Inc. I greatly appreciate the comments Vervoort,1Vervoort D. Centralization regionalization congenital heart surgery in globalized world.J Thorac Cardiovasc Surg. 2021; 161: e481Abstract Full Text PDF PubMed Scopus (7) Google Scholar who his letter editor encourages us focus on global level. His summary statement that question often one revenue, pride, and/or politics extremely accurate telling. Vervoort points out with advent new cardiac surgical centers low- middle-income countries, we must encourage them not repeat same mistakes already occurred many high-income countries. Governments developing need fewer greater volume per center improve outcomes while simultaneously promoting efficiency, reducing health system costs, ensuring specialized workers across all layers care. This exactly what was done Sweden, these changes should be recommended existing care systems only United States but also pediatric There increasing evidence greater-volume properly located can both actually decrease travel distance those needing Those live countries learned lesson hard way error repeated Regionalization children disease now truly issue, responsibility its inception rests our profession. worldThe Thoracic Cardiovascular SurgeryVol. 161Issue 6PreviewCongenital complex dedicated services optimize surgeons' skills patient outcomes. enables pooling by surgeons, whilst trying limit geographic barriers patients as result such decisions. Backer1 illustrates pursuit excellence using example Sweden's shift from 4 2 1992. Full-Text countries: Principles promiseThe 163Issue 1PreviewWe read correspondence Drs Vervoort,1 Backer,2,3 Karamlou4 regarding (CHS) (LMICs). discussion at Children's Heartlink had over second half 52-year history working different LMICs, majority underinvested services.