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English lessons: can publishing an atlas of variation stimulate the discussion on appropriateness of care?

Health systems around the world are facing the twin pressures of increasing demand for services, caused by the impact of ageing populations and medical science developments, and a lack of resources as a consequence of economic slowdown in many countries.1 In these circumstances, it should not be surprising that there is an increased focus on using available resources to deliver high quality care and addressing variation in the provision, uptake and costs of health care2 with a view to identifying and reducing unwarranted variation.

The ubiquity of recognition of variation35 continues to raise the profile of variation, capturing the imagination of researchers and policy makers6 to pose a challenge to those planning and delivering health care. That challenge runs much deeper than the undemanding observation and recording of variation, to one which must stimulate clinicians, managers and patient groups across the health care system into urgent and necessary action to identify and reduce unwarranted variation. That action is essential, not only as a means of enabling the health care systems to close their funding shortfalls, but more importantly to reduce harm to patients, improve the quality of services and increase value from resources. This is the focus of the…