Safety and Quality > Australian Atlas of Healthcare Variation Series

The Australian Atlas of Healthcare Variation series explores the extent to which healthcare use in Australia varies depending on where people live, investigating reasons for variation that may be unwarranted, and providing specific achievable actions to reduce unwarranted variation.

It uses maps of variation in care, derived from information routinely gathered by the health system, to show how healthcare use differs across the country and to raise important questions about why this variation might be occurring.

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Aims of the Atlas

The Atlas maps healthcare use across Australia to:

  • Identify variation
  • Promote investigation of the reasons for variation
  • Reduce unwarranted variation and promote appropriate care by recommending actions for:
    • reducing harm
    • improving equity of access to evidence-based care and delivering services more fairly
    • informing consumers, and promoting shared decision making
    • investigating patterns of clinical management and addressing gaps in health systems
    • improving usefulness of existing data
    • guiding value-based care

Rates of an intervention that are substantially higher or lower in some areas can highlight:

  • Uncertainty about the intervention’s place in therapy, and the need for better data on its benefits and harms
  • Gaps in accessible evidence for clinicians, and the need for clinical care standards
  • Inadequate system supports for appropriate care, and the need for changes in training or financial incentives.

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Why measure variation in healthcare use?

Getting the best outcomes for patients and reducing harm are the goals of the Atlas. Where we see substantial variation in use of a particular treatment, it is an alarm bell that should make us stop and investigate whether appropriate care is being delivered.

Variation in itself is not necessarily bad, and it can be good if it reflects health services responding to differences in patient preferences or underlying needs. When a difference in the use of health services does not reflect these factors, it is unwanted variation and represents an opportunity for the health system to improve.

Looking at how healthcare use varies between people living in different areas, between people with and without socioeconomic disadvantage, and between Aboriginal and Torres Strait Islander Australians and other Australians can show who

in our community is missing out. Fundamental changes to address the underlying determinants of ill health, as well as better service delivery for those with existing disease, are needed where these inequities are found.

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The Atlas Series

The first Atlas was published in 2015 and focused on care related to antibiotic prescribing, surgical, mental health and diagnostic services.  The second Atlas, released in 2017, examined chronic disease and infection – potentially preventable hospitalisations, cardiovascular conditions, women’s health and maternity and surgical interventions. The third Atlas published in 2018 examines neonatal and paediatric health, thyroid and gastrointestinal investigations and treatments and cardiac tests. It also focuses on changes over time in prescribing behaviour, with a repeat analysis of prescribing over four years for antimicrobial, opioid and psychotropic medicines.

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Who has developed the Atlas series?

The Commission has led development of the Atlas series. The first Atlas was developed in collaboration with the National Health Performance Authority (NHPA) in 2015 and the second and third Atlases with the Australian Institute of Health and Welfare (AIHW) in 2017 and 2018. NHPA and AIHW have contributed enormous expertise in their analysis and understanding of the data and data sources. State, territory and Commonwealth health departments have also been pivotal partners in providing data and in working with the Commission to interpret findings and find potential avenues for improvements in healthcare delivery.

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Development of each Atlas has involved extensive consultation across the country. Clinical topic experts, primary care experts and researchers with representatives from the private sector and state, territory and Commonwealth governments have contributed to the content development and project oversight.

A list of consultation groups can be found here.

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Contact us

You can contact the Atlas team via email:

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