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The effect of distance on the use of emergency hospital services in a Spanish region with high population dispersion: a multilevel analysis.

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dc.contributor.authorSanz-Barbero, Belén
dc.contributor.authorOtero Garcia, Laura
dc.contributor.authorBlasco-Hernandez, Teresa
dc.date.accessioned2020-06-09T10:28:21Z
dc.date.available2020-06-09T10:28:21Z
dc.date.issued2012-01
dc.description.abstractThere is geographic variability in the use of hospital emergency services. The effect of distance to the hospital on this variability is unknown. (a) To analyze the independent effect of distance on use of hospital emergency services; (b) to describe the variability among municipalities in use of hospital emergency services and to analyze how much of this variability is explained by distance. Weighted cross-sectional data from the 2003 Regional Health Survey of Castile and Leon were linked with municipal-level data from the 2001 Census, municipal health resources, and distance from municipality to hospital. : Sample of 4281 adults residing in 179 municipalities of the region of Castile and Leon. Using multilevel logistic regression models with random intercept, we analyzed the association between distance to hospital and use of hospital emergency services. The proportion of the sample using hospital emergency services in the last year was 14.4%. The multivariate analysis showed a significant inverse association between distance to hospital and use of emergency services (P=0.001). Use of hospital emergency services varied widely across municipalities (variance 0.484; standard error 0.132). Some 12.8% of the variability is attributable to differences among municipalities. The model explained 31.6% of the variability. : Distance is a barrier to accessing hospital emergency services. There is large variability among municipalities in the use of emergency services not explained by the model. Variables related with the capacity of primary care facilities to resolve emergencies may reduce part of the observed variability.es_ES
dc.description.peerreviewedSíes_ES
dc.description.sponsorshipFunding by National Health Funding Research. Project IP 080306.es_ES
dc.format.number1es_ES
dc.format.page27-34es_ES
dc.format.volume50es_ES
dc.identifier.citationMed Care . 2012 Jan;50(1):27-34.es_ES
dc.identifier.doi10.1097/MLR.0b013e31822d5e03.es_ES
dc.identifier.e-issn1537-1948es_ES
dc.identifier.issn0025-7079es_ES
dc.identifier.journalMedical carees_ES
dc.identifier.pubmedID21897301es_ES
dc.identifier.urihttp://hdl.handle.net/20.500.12105/10301
dc.language.isoenges_ES
dc.publisherLippincott Williams & Wilkins (LWW)es_ES
dc.relation.projectIDinfo:eu_repo/grantAgreement/ES/IP 080306es_ES
dc.relation.publisherversionhttps://doi.org/10.1097/MLR.0b013e31822d5e03es_ES
dc.repisalud.centroISCIII::Escuela Nacional de Sanidades_ES
dc.repisalud.centroISCIII::Centro Nacional de Medicina Tropicales_ES
dc.repisalud.institucionISCIIIes_ES
dc.rights.accessRightsopen accesses_ES
dc.rights.licenseAtribución-NoComercial-CompartirIgual 4.0 Internacional*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/4.0/*
dc.subject.meshAdolescentes_ES
dc.subject.meshAdultes_ES
dc.subject.meshAge Factorses_ES
dc.subject.meshCross-Sectional Studieses_ES
dc.subject.meshEmergency Service, Hospitales_ES
dc.subject.meshFemalees_ES
dc.subject.meshGeographyes_ES
dc.subject.meshHealth Services Accessibilityes_ES
dc.subject.meshHealth Services Researches_ES
dc.subject.meshHumanses_ES
dc.subject.meshMalees_ES
dc.subject.meshMiddle Agedes_ES
dc.subject.meshRural Populationes_ES
dc.subject.meshSex Factorses_ES
dc.subject.meshSpaines_ES
dc.subject.meshYoung Adultes_ES
dc.titleThe effect of distance on the use of emergency hospital services in a Spanish region with high population dispersion: a multilevel analysis.es_ES
dc.typejournal articlees_ES
dc.type.hasVersionSMURes_ES
dspace.entity.typePublication
relation.isAuthorOfPublicationda543d59-93ad-41cd-93a8-cc16a026ad94
relation.isAuthorOfPublication1d617902-5466-4ba3-a48f-fed16bbeda7b
relation.isAuthorOfPublication13de3112-2f6c-452e-9f65-1738be8de0f7
relation.isAuthorOfPublication.latestForDiscoveryda543d59-93ad-41cd-93a8-cc16a026ad94
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