Publications

Geographic Variations in Health Care

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

In series:OECD Health Policy Studiesview more titles

Published on September 16, 2014

book

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.

TABLE OF CONTENTS

Foreword and Acknowledgements
Acronyms and abbreviations
Executive summary
Geographic variations in health care use in 13 countries: A synthesis of findings
Australia: Geographic variations in health care
Belgium: Geographic variations in health care
Canada: Geographic variations in health care
Czech Republic: Geographic variations in health care
Finland: Geographic variations in health care
France: Geographic variations in health care
Germany: Geographic variations in health care
Israel: Geographic variations in health care
Italy: Geographic variations in health care
Portugal: Geographic variations in health care
Spain: Geographic variations in health care
Switzerland: Geographic variations in health care
United Kingdom (England): Geographic variations in health care
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NEWS AND EVENT

Whether or not a patient receives a particular health service depends to a great extent on the country in which he or she lives – and on the geographical area within a country. Wide variations in health care use exist across and within countries, but we still do not know whether high use is due to the provision of unnecessary procedures, or whether low use signals unmet need. Some of the very large geographic variations observed cannot be fully explained by differences in patient need or preferences. These unwarranted variations remain, signalling that health systems are not achieving the level of performance they could. Governments should step up efforts to ensure better use of health services.

 

The OECD publication was released at a joint conference organised by the OECD and the Bertelsmann Foundation on September 16, 2014.
This event targeted German stakeholders to discuss geographic variations and where Germany stands in an international context.

Visit https://faktencheck-gesundheit.de/ for more information. The programme of the conference is available online.

> Read the press release in German: Rein medizinisch nicht erklärbar: In manchen Regionen wird acht Mal häufiger operiert als andernorts
> Read the chapter about Germany (in German): Deutschland: Geografische Variationen in der Gesundheitsversorgung 

 

KEY COUNTRY FINDINGS

 

DATA AND PRESENTATION

 Available in SlideShare - Download the PDF

FURTHER READING

CONTACT US

Valérie Paris (valerie.paris@oecd.org)
Gaetan Lafortune (gaetan.lafortune@oecd.org)

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