[Healthcare resources and premature mortality from ischemic heart disease in Spain: An ecological analysis...

To analyze the association between healthcare resources and premature mortality from ischemic heart disease in the Spanish autonomous communities between 2018 and 2023.

An observational ecological study was conducted using aggregated data by autonomous community and year. The dependent variable was premature mortality from ischemic heart disease (< 75 years, adjusted for age). Independent variables included primary care physician density and per capita healthcare expenditure. Descriptive statistics, Pearson correlations, and multiple lineal regression were applied.

The average premature mortality rate was 20.53/100,000 inhabitants (SD=4.59), being higher in men (34.21 vs. 7.66 in women) and in the Canary Islands, Asturias, and Andalusia. The rate remained stable over time (19.91-21.04/100,000). No significant associations were found between mortality and healthcare resources. However, healthcare expenditure correlated positively with the density of primary care physicians (r=0.307; P=.001).

Although the availability of healthcare resources did not explain the differences in premature mortality, this study highlights the persistent territorial and sex-based heterogeneity in Spain and the need for comprehensive strategies that combine investment, prevention, and the reduction of inequalities. The findings provide useful evidence for planning cardiovascular health policies at the regional level.