Variation in operation rates by primary care trust

Variation in the use of surgical procedures has been well documented in the US, England and Norway.^{w1 w2} With increasing emphasis in health care on clinical guidelines,^w3 service frameworks,^w4 and evidence based medicine,^{w5 w6} one might expect to see less variation in practice over time. Using hospital episode statistics, we looked at trends in variation between primary care trusts in operation rates for 10 common procedures over six years from 1998-9 to 2003-4.