Small area variations refer to the differences in the utilization and costs of healthcare services among geographically defined regions or small areas within a larger geographic entity, such as states, counties, or cities. This concept emerged in the field of healthcare research, specifically health services research, to understand the geographic variation in healthcare delivery and its impact on health outcomes and costs.
The term "small area variations" was first introduced by John Wennberg and his colleagues at the Dartmouth Atlas Project in the 1970s. This research initiative focused on exploring the differences in healthcare practices across various regions in the United States. Small area variations analysis involves using data from administrative sources such as claims data or population surveys to examine the rates of medical procedures, tests, hospitalizations, and healthcare spending in different areas.
Small area variations are influenced by factors such as local healthcare delivery systems, provider practices, patient preferences, availability of healthcare resources, and demographic characteristics of the population. Understanding these variations can provide valuable insights into the effectiveness, efficiency, and equity of healthcare services provided in different regions. Small area variations research aims to identify patterns of healthcare delivery that can inform policy decisions and help improve the quality and outcomes of healthcare.
By identifying areas with higher or lower utilization, researchers can also investigate potential overuse, underuse, or misuse of healthcare resources, and explore geographical disparities in access to care. Small area variations analysis has become an important tool in health services research, contributing to the evidence base for healthcare quality improvement, resource allocation, and health policy development.
