About Atlas VPM


The "project Atlas VPM", Atlas of Variations in Medical Practice in the National Health System, is a nationwide Health Services Research (HSR) Program concerning the analysis of unwarranted variations in medical practice and healthcare outcomes in Spain. The idea was to compare healthcare geographically – region by region – with a view to giving powerful feedback to policy decision-makers and managers nationwide.

In order to do this, the project collaborated with the regional health authorities in Spain to acquire hospital data on the patient level. These data were then amassed into a central database and then an online analysis tool was built as a front-end to the database. This meant that policymakers, managers and other stakeholders could go directly to the Atlas website and themselves conduct research on key issues in a matter of seconds or minutes.

The project team also conducted their own research and Atlas VPM has published seven atlases, and several reports and papers. Among other issues these publications cover: unwarranted variations in general surgery, orthopaedics, paediatric hospitalizations, cardiovascular procedures, mental health hospital care, oncologic surgery, avoidable hospitalizations, c-section rates, and patient safety or mortality in cardiovascular procedures.



Group coordinator


The "project Atlas VPM" is coordinated by Health Services and Policy Research Unit-ARiHSP, Health Sciences Institute in Aragon (IACS) IIS Aragón and y Health Services and Policy Research Area, Centro Superior de Investigación Salud Pública de Valencia, CSISP.



Research team


Atlas VPM are a group of over 50 professionals in medical services of the 17 regional governments of Health working on the project.



What we do?

  ATLAS. More detail: Spanish Version

    • Atlas 1. Variability in Orthopaedic and Trauma Surgery. Hip fracture, knee replacement and hip replacement.
    • Atlas 2. Variability in General Surgery interventions in Spanish National Health System.
    • Atlas 3. Variability in pediatric hospitalizations for selected diagnoses and surgical procedures.
    • Atlas 4. Variability in hospitalization for cardiovascular problems and procedures in the National Health System.
    • Atlas 5. Variability in the rate of hospitalizations for mental health problems in acute hospitals.
    • Atlas 6. Variability in Hospitalisations due to onclolgical surgery in the National Health System. In this Atlas we describe the differences across surgery utilisation in the treatment of 9 cancer types: breast, bladder, colorectal, prostate, uterus, larynx, lung, stomach and esophagus, between the years 2005 and 2007. English interactive version
    • Atlas 7. Variability in hospitalizations of older people in the National Health System.
    • Atlas 8. Variability in Potentially Avoidable Hospitalizations related to chronic diseases


  • APOTHEKES. Atlas VPM provides small "methodological pills" as documents explaining the methodology used, thus making it easier to understand their findings
  • PROJECTS. More details: spanish version
    • RETIC: Health Services Chronic Disease
    • Developing a strategy for the NHS disinvestment from unwarranted monitoring variations in the use of procedures of dubious clinical value
    • ECHO European Collaboration for Health Care Optimization. www.echo-health.eu
    • Spatio-temporal evolution of unjustified variations in medical practice in the NHS










ECHO. (The European Collaboration for Health Optimization) 
. (Red de investigación en Servicios de Salud en Enfermedades Crónicas) 
 (Addressing Chronic Disease and Healthy Ageing across the Life Cycle)


Si desea más información: atlasvpm.iacs@aragon.es

Proyecto ECHO- www.echo-health.eu


Red de investigación en servicios de salud en enfermedades crónicas.- www.redissec.com/es/






Where we are



Atlas VPM - Atlas de Variaciones de la Práctica Médica

Instituto Aragonés de Ciencias de la Salud- I+CS

Edificio CIBA
Avda. San Juan Bosco, 13
50009 Zaragoza-Spain
T.: 976. 71.6837/ 5483
F.: 976.71.4670