Send to

Choose Destination
Int J Qual Health Care. 2018 Nov 1;30(9):731-735. doi: 10.1093/intqhc/mzy092.

Medical practice variation: public reporting a first necessary step to spark change.

Author information

Radboud University Medical Center/Radboud Institute for Health Sciences/Scientific Center for Quality of Healthcare (IQ healthcare), 114 IQ healthcare, 6500 HB Nijmegen Geert Grooteplein 21, Nijmegen, The Netherlands.
The Dartmouth Institute for Health Policy and Clinical Practice, 1 Medical Center Drive; WTRB Level 5 Lebanon, NH, USA.
Health Quality & Safety Commission New Zealand, Wellington, Wellington, New Zealand.
NHS RightCare, 5th Floor Stephenson House, 75 Hampstead Road, London, UK.


From previous work, we know that medical practice varies widely, and that unwarranted variation signals low value for patients and society. We also know that public reporting helps to create awareness of the need for quality improvement. Despite the availability of rich data, most Western countries have no routine surveillance of the geographic distribution of utilization, costs, and outcomes of healthcare, including trends in variation over time. This paper highlights the role of transparent public reporting as a necessary first step to spark change and reduce unwarranted variation. Two recent examples of public reporting are presented to illustrate possible ways to reduce unwarranted variation and improve care. We conclude by introducing the Value Improvement Cycle, which underscores that reporting is only a necessary first step, and suggests a path toward developing a multi-stakeholder approach to change.

[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Silverchair Information Systems Icon for PubMed Central
Loading ...
Support Center