title: Atlas of Variations in Medical Practice in Spain: the Spanish National Health Service under scrutiny.
abstract: Early in the 2000s, a countrywide health services research initiative was launched under the acronym of Atlas VPM: Atlas of Variations in Medical Practice in the Spanish National Health System. This initiative aimed at describing systematic and unwarranted variations in medical practice at geographic level-building upon the seminal experience of the Dartmouth Atlas of Health Care. The paper aims at explaining the Spanish Atlas experience, built upon the pioneer Dartmouth inspiration. A few selected examples will be used along the following sections to illustrate the outlined conceptual framework, the different factors that may affect variation, and some methodological challenges.
authors.affiliation: Institute for Health Sciences in Aragón, IIS Aragón, c/San Juan Bosco 13, 50009 Zaragoza, Spain. Electronic address: ebernal.iacs@aragon.es.
authors.forename: Enrique
authors.initials: E
authors.lastname: Bernal-Delgado
authors.affiliation: Institute for Health Sciences in Aragón, IIS Aragón, ARAI+D Foundation, Spain.
authors.forename: Sandra
authors.initials: S
authors.lastname: García-Armesto
authors.affiliation: Centro Superior de Investigación en Salud Pública, Valencia, Spain.
authors.forename: Salvador
authors.initials: S
authors.lastname: Peiró
mesh_terms: D001271:Atlases as Topic; D017281:Cost of Illness; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D062306:Geography, Medical; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D009313:National Health Programs / Q000592:standards / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013030:Spain / Q000453:epidemiology
keywords: Geographic variations in medical practice; Health system performance assessment; Spanish Atlas of Variations in Medical Practice, Spain