Reference Work Entry

Medical Practice Variations

Part of the series Health Services Research pp 41-52


Medical Practice Variations in Acute Care Hospitalization

  • Kimberlyn McGrailAffiliated withCentre for Health Services and Policy Research, University of British Columbia Email author 
  • , Steven LewisAffiliated withAccess Consulting Ltd.


Acute hospitals are the largest single component of health care budgets. Only a small percentage of the population encounters acute inpatient care in any given year, but these are the sites for the most intensive (and most expensive) care provided in the health care system. Anyone who is admitted to acute care will also use other parts of the health care system, and many who do not use hospital care may be considered at risk for admission.

The literature on acute care variations is extensive. Studies about varying rates of admission, readmissions, and length of stay are common, as are studies of different types of procedures performed in hospital settings. Most studies of hospital care, however, do not situate that care in this broader context of ongoing patient trajectories.

This chapter draws on existing literature to describe medical practice variations in acute care in that broader context. These variations have implications for the overall cost and quality of any health care system. Acute care must be understood not as an entity in itself but as both a precursor to and outcome of events and services that occur in other parts of the health care system.