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As well as considering ‘snapshot’ rates of provision of a practice in a given year or over a given period, it is interesting to compare how these rates have evolved, in the country as a whole or in a particular area. Significant differences can be observed, which can be explained by the epidemiology of the underlying pathology, differences in access to care or heterogeneous therapeutic choices.

Furthermore, high rates with an upwards trend, for example, are interpreted differently from high rates which are levelling out or declining.

This latter scenario can be seen if we analyse trends in the rates of tonsillectomies and adenoidectomies carried out. The graph shows clearly (see figure below) that the arrondissement with the highest rate in 2017 has also experienced the steepest decline since 2012.

Variations Trends