Centralization of surgery: is it applicable to less populous nations?

The practice of surgery has witnessed substantial evolution over the recent years, especially with significant advancements in the field of medical diagnostics and surgical therapies. Establishment of specialized and super-specialized surgical centers has resulted in concentrated distribution of patient caseload. There is an immense thrust towards the centralization of surgery particularly for complex high-risk procedures in the Western World. However, such concepts may not apply to less populous nations, and the adoption of healthcare delivery system of specialized centers by low-volume hospitals may produce overall better outcomes.