title: Megavoltage irradiation in a district general hospital remote from a main oncology centre: the Torbay experience reviewed.
abstract: A recent Royal College of Radiologists' report on the organization of clinical oncology services supports a greater consultant presence in district general hospitals but condemns satellite treatment facilities. However, new contract costs for treatment in remote main centres may induce 'client' purchasers or providers to re-examine the economics and benefits of a local facility. This article reviews the experience of a satellite facility, and suggests a minimum critical mass of capital and revenue below which such facilities are uneconomic, but above which savings can be expected. Comparison of outcomes for radical treatment overall with the local main centre and, for head and neck malignancy, with a large regional centre elsewhere, suggests no compromise of technical standards. Convenience for patients and carers is high and has resulted in a high uptake of services in the satellite-equipped district.
authors.affiliation: Torbay Hospital, Lawes Bridge, Torquay.
authors.forename: C R
authors.initials: CR
authors.lastname: Penn
mesh_terms: D002497:Centralized Hospital Services / Q000191:economics; D004739:England; D006767:Hospitals, District / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D006769:Hospitals, General / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D009369:Neoplasms / Q000191:economics / Q000401:mortality / Q000532:radiotherapy; D016522:Oncology Service, Hospital / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D011882:Radiotherapy, High-Energy / Q000191:economics / Q000706:statistics & numerical data; D016896:Treatment Outcome; D000078329:Workforce