Understanding Geographic Variations in Health Care Delivery

Abstract

Geographic variations in health care delivery have been widely documented in the United States, Canada, Europe, and Australia. Most studies have concentrated on cross-sectional variations in the rates of surgical procedures. The study by Ashton et al. in this issue of the Journal is one of the few to analyze variations in the rates of hospitalization for groups of patients with chronic conditions.¹ The introduction of the issue of variations in practice patterns into the debate on medical quality and efficiency in the Department of Veterans Affairs (VA) health care system comes at a time of unusual commitment to action . . .