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Geographic Variations in Health Care

What Do We Know and What Can Be Done to Improve Health System Performance?

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Variations in health care use within a country are complicated. In some cases they may reflect differences in health needs, in patient preferences or in the diffusion of a therapeutic innovation; in others they may not. There is evidence that some of the observed variations are unwarranted, signalling under- or over-provision of health services, or both. This study documents geographic variations for high-cost and high-volume procedures in select OECD countries. It finds that there are wide variations not only across countries, but within them as well. A mix of patient preferences and physician practice styles likely play an important part in this, but what part of the observed variations reflects over-provision, or whether there are unmet needs, remain largely unexplained. This report helps policy makers better understand the issues and challenges around geographic variations in health care provision and considers the policy options.

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Foreword and Acknowledgements

Whether or not you will receive a particular health service depends to a very great extent on the country in which you live – even countries with similar standards of living deliver very different packages of health services – but also on the region where you live within a country. To the extent that variations in the use of different diagnostic or therapeutic procedures reflect differences in health needs or patient preferences, there is no cause for concern. But if they do not, they are unwarranted, signalling either under- or over-utilisation of care in some areas, which in turns raises questions about the equity and the efficiency of health systems and overall health system performance.

English

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