Organizing contemporary oncology care together - A scoping review on multi-hospital oncology networks

Introduction: In oncology, hospitals increasingly collaborate in multi-hospital networks to deliver high-quality care. However, it is unclear how these networks should be organized and whether they are effective. Methods: Following PRISMA-ScR guidelines, this scoping review included peer-reviewed studies on multi-hospital oncology networks of three or more autonomous hospitals collaborating to deliver services and improve quality of care in high income economies, published in English. Results: The search yielded 4.013 hits, of which 47 articles were included. Results revealed that the research field is relatively young, remains in part descriptive, and is highly fragmented, leaving questions about the optimal organization of multi-hospital networks. Although multi-hospital networks exhibit similar, centralized structural features, they vary in the way they are governed. Furthermore, although network outcomes are generally positive, studies predominantly focus on process-outcomes rather than patient-outcomes and often suffer from methodological flaws. Policy summary: Insights from this review can be used by clinicians and hospital leaders to enhance their chances of network success, and by researchers as a guide for future studies. Multi-hospital oncology networks are increasingly organized, often as centralized hub-and-spoke models. To ensure these networks truly benefit patients, policies could support balanced collaboration between expert and non-expert centers, strengthen joint decision-making, and focus on patient outcomes rather than only process improvements. Further research on these networks is needed to better inform policy. This requires shared terminology, strengthened study designs, and integration of insights across fields. Registry Name and Number: This review is pre-registered at Open Science Framework (blinded for peer review).