Australian Commission on Safety and Quality in Health Care launches first Australian Atlas of Healthcare Variation

Actions recommended to improve health care nationally

The Honourable Sussan Ley, Australian Minister for Health, launches the first national healthcare ‘atlas’, illuminating variation in health care provision across Australia.

The Australian Atlas of Healthcare Variation presents a clear picture of substantial variation in healthcare use across Australia, across areas such as antibiotic prescribing, surgical, mental health and diagnostic services.

Some variation is expected and associated with need-related factors such as underlying differences in the health of specific populations, or personal preferences. However, the weight of evidence in Australia and internationally suggests that much of the variation documented in the atlas is likely to be unwarranted. Understanding this variation is critical to improving the quality, value and appropriateness of health care.

Six clinical areas are examined in the atlas, covering prescribing, diagnostic, medical and surgical interventions. Priority areas for investigation and action include the use of antimicrobials and psychotropic medicines; variation in rates of fibre optic colonoscopy, knee arthroscopy, hysterectomy and endometrial ablation; and inequitable access to cataract surgery.

The Australian Commission on Safety and Quality in Health Care (the Commission) collaborated with the Australian, state and territory governments, specialist medical colleges, clinicians and consumer representatives to develop the atlas.

It is the first time that data from the Medicare Benefits Schedule (MBS), Pharmaceutical Benefits Scheme (PBS) and Admitted Patient Care National Minimum Data Set (APC NMDS) have all been used to explore variation across different healthcare settings. The atlas is presented alongside the first national recommendations for action.

Atlas Advisory Group Chair, Professor Anne Duggan said the atlas identified opportunities for improving the healthcare Australians receive.

“The atlas identifies a number of geographic and clinical areas where marked variation in practice is occurring. This means that people with the same health conditions, concerns or problems may not be receiving the same care as others, elsewhere, with the same problems,” said Professor Duggan.

“This raises concerns that we have unwarranted variation in our health care system – now the challenge is to work out what is right.

“This atlas is the first in a series, and while it represents a significant step forward, much more work is needed. The atlas should be seen as a catalyst for generating action, with the ultimate aim of improving people’s care and outcomes, through improving the efficiency and effectiveness of the healthcare system,” said Professor Duggan.

Professor Villis Marshall AC, Chair of the Commission Board, also commented on the atlas, saying it embodied a shared aim of providing information to improve the appropriateness of care for populations and individuals in Australia and increasing the value obtained from resources allocated to health.

“The atlas findings and recommendations will make a substantial contribution to improving the quality of health care in this country,” Professor Marshall said.

“Australia has a world-class health system but it is crucial we study what these variations might tell us about how to do things better and more consistently in the future.

“The atlas is a powerful resource to help us identify and reduce unwarranted variation in health care, while also highlighting some population health concerns that warrant further investigation,” Professor Marshall said.