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Health care variation: time to act

Why are knee replacement rates in Australia over four times higher than they are in Israel? Or the rate for caesarean deliveries nearly twice as high as in Finland? These findings come from an Organisation for Economic Co-operation and Development report that highlighted substantial variation in the rates of several common health care interventions both across and within 13 countries.1 These types of geographic variations in health care use have been consistently demonstrated over long periods of time and for a vast range of clinical interventions.26

Variation in health care use across Australia has now been mapped in the recently published Australian atlas of healthcare variation, produced by the Australian Commission on Safety and Quality in Health Care (ACSQHC) and the National Health Performance Authority.7 Health care use by location of patient residence is mapped using standard geographic regions. Rates are standardised by age to adjust for age differences between different geographic populations. Data used to produce the Atlas have come from three datasets: the Admitted Patient Care National Minimum Data Set (APC NMDS), covering patients admitted to public and private hospitals; the Medicare Benefits Scheme (MBS) claims database (use of medical services,…