REDUCING HEALTH VARIATIONS

Review of the research on the effectiveness of health service interventions to reduce variations in health

Background

The aim of this project was to review the available research in order to identify evaluations of interventions which the NHS alone, or in collaboration with other agencies, could use to reduce variations in health.

Findings

There are interventions which the NHS, either alone or in combination with other agencies, can use to reduce variations in health. Whilst removal of the financial barriers to accessing health care can make an important contribution to reducing variations in health, this is not in itself sufficient to prevent all avoidable variation.

This review has shown that good experimental methods such as randomised controlled trials can be used to carry out rigorous evaluations of interventions to reduce variations in health. Further coordinated and rigorous evaluations of promising interventions would be useful, as would research to estimate the proportion of the total variation in health which could be reduced by means of health service interventions of the type described. Commissioners of health services could additionally undertake an "equity audit" of the services they commission to identify priority areas for interventions and monitor change.

It is hoped that the effective interventions identified in the review will help purchasers and providers of health services at local level use their resources more equitably and assist in the shaping and evaluation of future initiatives designed to address variations in health.

Conducted by: CRD

Publications

NHS Centre for Reviews and Dissemination. Review of the research on the effectiveness of health service interventions to reduce variations in health. CRD Report 3. York: University of York. 1995

Arblaster L, Lambert M, Entwistle M, Forster M, Fullerton D, Sheldon T, Watt I. A systematic review of the effectiveness of health service interventions aimed at reducing inequalities in health. J Health Serv Res Policy. 1996;1(2):93-103

Funding

Commissioned by the NHS Executive