Regional differences in hospital use by adults in Spain

The purpose of this paper was to study regional differences in the use of in patient hospital services by adults in Spain and to explore how several factors are related to hospital utilization. We studied a sample of 20,741 individuals representative of the non-institutionalized Spanish population older than 15 years old interviewed in the Spanish health interview survey, carried out in 1993. A logistic regression model was used to obtain the odds ratios of using the in-patient hospital services for socioeconomic status, health care need, health services resources characteristics and for the 17 autonomous communities into which Spain is divided. Aragon, Baleares and Navarra showed a high percentage of people using hospital services while in Madrid and Asturias a low percentage was found. Indicators of need for health care were the most important predictive factors of hospital utilization and neither socioeconomic status nor health care system characteristics were associated with the use of hospital services. Although only 5 autonomous communities showed a high or low percentage of people using hospital services, the unexplained variance needs further research in order to identify unnecessary reasons for utilization and accessibility problems.