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Updated: Jan 19, 2026

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Identifying and quantifying variation between healthcare organisations and geographical regions: using mixed-effects
1University of Exeter Medical School (Primary Care), Exeter, UK g.a.abel@exeter.ac.uk.
Abstract:
When the degree of variation between healthcare organisations or geographical regions is quantified, there is often a failure to account for the role of chance, which can lead to an overestimation of the true variation. Mixed-effects models account for the role of chance and estimate the true/underlying variation between organisations or regions. In this paper, we explore how a random intercept model can be applied to rate or proportion indicators and how to interpret the estimated variance parameter.
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