Abstract

Two fold variations in the age and sex standardised post mortem prevalence of gallstones have been demonstrated between nine British towns by Barker and his colleagues. We have examined the rates of cholecystectomy in the Districts serving seven of these towns to discover whether the incidence of operation bears any relation to this variation in morbidity. The opportunity to compare independent measurements of morbidity with the supply of health services and their use is rare, and in this example a plausible association is demonstrated. Variations in cholecystectomy rates between countries is, however, more difficult to explain by variations in relevant morbidity.