Regional differences in hospital use by adults in Spain

The purpose of this paper was to study regional differencesin the use of in-patient hospital services by adults in Spainand to explore how several factors are related to hospital utilization.We studied a sample of 20,741 individuals representative ofthe non-institutionalized Spanish population older than 15 yearsold interviewed in the Spanish health interview survey, carriedout in 1993. A logistic regression model was used to obtainthe odds ratios of using the in-patient hospital services forsocioeconomic status, health care need, health services resourcescharacteristics and for the 17 autonomous communities into whichSpain is divided. Aragon, Baleares and Navarra showed a highpercentage of people using hospital services while in Madridand Asturias a low percentage was found. Indicators of needfor health care were the most important predictive factors ofhospital utilization and neither socioeconomic status nor healthcare system characteristics were associated with the use ofhospital services. Although only 5 autonomous communities showeda high or low percentage of people using hospital services,the unexplained variance needs further research in order toidentify unnecessary reasons for utilization and accessibilityproblems.