Health Atlas central to the National Audit Office's report
The National Audit Office, with the help of health atlases from SKDE, has examined the variation in the use of specialist healthcare services. The investigation shows that hospitals do not adequately address undesirable variation.
Published 2/27/2026
Photo: Per-Kristian Foss
The National Audit Office has gathered information from all health atlases that have been published and finds that there is, overall, undesirable variation in more than half of all health services presented.
The investigation conducted concludes with the following main points:
- There is undesirable variation in the consumption of a number of specialist health services between the health trusts' catchment areas
- Systematic differing assessments of similar conditions contribute to undesirable variation in the consumption of specialist health services
- The regional health trusts do not utilise capacity regulation effectively enough as a tool to reduce undesirable variation in consumption
- The regional health trusts and health enterprises have, to a limited extent, used consumption rates to monitor professional practice and capacity
Knowledge of variation is not enough
All four health regions have produced or commissioned their own analyses based on the health atlases, but despite the fact that the health trusts have gradually gained good knowledge of undesirable variation in consumption, the National Audit Office assesses that there is still significant variation.
According to the report, this suggests that possible measures have not been used effectively enough to reduce undesirable variation. In the audit's view, obtaining management information is a necessary but not sufficient measure to reduce undesirable variation in consumption.
Through in-depth interviews with doctors and other healthcare personnel, as well as a review of improvement measures implemented in some health trusts, the National Audit Office asserts that a conscious attitude and concrete actions are required to keep the consumption of health services at a low but defensible level.
Calls for clearer requirements
The audit believes that the regional health trusts have not set clear enough requirements for the health enterprises and that they can follow up these requirements more systematically than they have done so far.
At the same time, efforts to reduce undesirable variation and any changes in practice must be anchored with the clinicians who make decisions regarding investigation and treatment. Additionally, clear decision support in the form of guidelines can contribute to more uniform practice.