Atlas of unwarranted variation in the quality of hospital care

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ISSN: 2529-9255 Vol.7 Online Quality- Last updated: December 2021

About this Atlas

The atlas of unjustified variations in the quality of hospital care represents the performance of the acute hospitals of the NHS in the treatment of those diagnoses or surgical procedures usually considered to measure the quality of hospital care, through the study of the risk of in-hospital mortality in 2018.

For each hospital centre analysed within the diagnosis and procedure indicators, three types of complementary results are shown, the crude rate, the standardised ratio (quotient between the observed values and the expected values) and the relative position of the latter, resulting from the comparison of each unit of analysis with respect to a benchmark (the unit).

Update of this atlas

This update includes a new section “Time projection”, which shows, in addition to the monthly evolution of the expected values of success for each of the indicators, the monthly projection for 2 years.

The Variability section shows the map with the geolocation of the hospitals analysed, according to the indicator, with the results for the last year of the available period, 2018. This section also includes the evolution of the standardised in-hospital mortality ratios (SMR) over the period 2003-2018.

The Performance Profile section represents the performance or behaviour of each of the analysed hospitals in the years 2015 and 2018 for all quality indicators. That is, the results of the last year of the period (year 2018) are shown, together with the last year of hospital activity registration through the ICD9-CM coding system (year 2015), from which point onwards the coding was changed to the ICD10 system.

Infographic: The Quality of Hospital Care
Downloadable documents about this atlas

Cite as: Comendeiro-Maaløe M, Martínez-Lizaga N, Troster V E, Seral-Rodríguez M, Ridao-Lopez M, Estupiñán-Romero F, Angulo-Pueyo E, Ibañez-Beroiz B, Librero-López J, Millán-Ortuondo E, Peiró-Moreno S, Bernal-Delgado E, by the Atlas VPM group. Atlas of unjustified variations in the quality of hospital care in the National Health System. April-December 2021; Available at:

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