REGIONAL VARIATION IN SURGICAL-PROCEDURE RATES IN FINLAND

The aim was to describe the regional variation of population based sur gery rates in Finland with special reference to the comparison of surg ical activities in individual hospitals. Data on 11 common procedures covering all Finnish hospitals were obtained from the Finnish Hospital Discharge Register and the Finnish Medical Birth Register of the year s 1987 and 1988. The variations of age and sex standardized procedure rates were studied across the procedure specific hospital service area s. The variation was estimated by three methods: extremal quotient, co efficient of variation, and systematic component of variation. The sta tistical significance of the variation measures was tested with a comp uterized simulation model. The variation was small for mastectomy, ing uinal hernia repair, and hip replacement due to fracture, and large fo r lumbar disc operations, haemorrhoidectomies, and uterus operations. The results are similar to those of comparable studies elsewhere. The results indicate that there are clear differences in surgical activiti es between Finnish hospitals.