Healthcare Variation
Understanding healthcare variation is an important step in improving patient outcomes and in supporting sustainability of the health system. This page explains why it is useful to measure healthcare variation, common underlying reasons for variation and how data can be used to improve care.
What is healthcare variation?
Healthcare variation occurs when people receive different care for the same condition, or care that does not reflect best practice.
Differences in the way the same condition is treated, or how much an intervention is used, are examples of healthcare variation. Variation can be warranted (appropriate), or unwarranted, depending on the underlying reason.
Warranted healthcare variation
Reflects differences in patient preferences or needs
Unwarranted healthcare variation
Does not reflect differences in patient preferences or needs. This represents an opportunity to improve.
Learn how to reduce unwarranted clinical variation using six evidence-based strategies through our new Better Care Everywhere initiative.
Why measure healthcare variation?
Getting the best outcomes for patients and reducing harm is the goal of measuring healthcare variation. Substantial variation in use of a particular treatment is an alarm bell that should make us reflect and investigate whether appropriate care is being delivered. Measuring, investigating and responding to healthcare variation can:
- Improve the safety and quality of care provided
- Promote equity by ensuring everyone gets the same standard of care
- Reduce waste through the identification of unnecessary tests or treatments
- Support shared decision-making by placing patient’s needs and preferences at the centre.
National Safety and Quality Health Service Standards
Action 1.28 of the NSQHS Standards requires health service organisations to identify potentially unwarranted clinical variation and regularly review and improve the appropriateness of clinical care.
Environmental sustainability
Providing care that is appropriate and high quality helps improve health outcomes and experiences. When health care is consistently appropriate, it minimises waste, lowers the environmental impact and supports a more sustainable health system for the future. Read more about environmental sustainability and health.
Reasons for healthcare variation
Reasons for variation in rates of health care use can include:
- Inequity of access to evidence-based care, and the need to deliver services more fairly
- 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.
Using data on healthcare variation to improve care
Healthcare variation data can be used at all levels of the health system to identify opportunities for improvement. These case studies highlight best practice in reviewing clinical variation across different healthcare settings.
Case study: A combination of Atlas data and a clinical care standard led to improvements in care for women with heavy menstrual bleeding
The Second Atlas found that women living in Ballarat had the second highest rate of hospitalisations for hysterectomy for benign conditions in Australia in 2014–15, prompting a review by staff at Ballarat Hospital. Auditing local data in light of the Heavy Menstrual Bleeding Clinical Care Standard prompted changes to ensure women were offered alternatives to hysterectomy.
Case study: Atlas data on psychotropic medicines prescribing led to state-level system changes and improved access to psychological services
Several areas of Tasmania were among the highest users in Australia of anxiety and depression medicines, according to the first Atlas. Primary Health Tasmania undertook a comprehensive needs assessment to gain a deeper understanding of the Atlas findings. Initiatives included increasing access to mental health services where gaps were found, audits of practice data and deprescribing resources.
Case study: State hospital admission data highlighted a problem with unplanned readmissions after paediatric tonsillectomy and led to development of a change package involving clinician and consumer resources
‘Everyone in the project was motivated to try to make things better. People from the different sites appreciated the chance to take time out from their clinical roles to talk to colleagues in similar roles from other hospitals.’
- Associate Professor Gillian Nixon, Clinical Lead for the project, paediatric respiratory and sleep physician, Monash University
See Case Studies of Clinical Variation in Health Care for more examples.
Better Care Everywhere - a new initiative to reduce unwarranted variation
The Better Care Everywhere initiative describes what appropriate care looks like across priority focus areas and provides a toolkit to help clinicians and health service organisations address the drivers of low-value care to deliver sustainable, high-quality care.