[Relationship between the distance to hospital emergency services and their utilization]

The relationship between the distance to the Elche County Hospital, grouping the towns in its area of influence into four categories (over 29 km, 20 to 19 Km, under 20 Km and Elche proper), and the rates regarding the use of this hospital's emergency room services are studied based on a sample of 3,546 emergency cases treated in said hospital in 1985. The relative standardized risks by age (RelR) are significantly greater than 1 in all categories regarding that of 29 Km, concerning both men (1.36, 2.64, 3.86) and women (1.52, 2.02, 3.87). This is an association which follows a statistically significant upward trend concerning men (X ext-Mantel = 21.63 p less than 0.01) and women (X ext-Mantel = -18.85 p less than 0.01) as the distance decreases. We point out the limitations of the study, and some implications of the inverse association found (b = -0.38 for men and -0.29 for women p less than 0.05) are discussed with regard to refocusing health care services.