[Primary care as a determinant of the utilization of hospital emergency services]

To study the characteristics of emergency care within Primary Care (ECPC), which determine the use of hospital emergency services (HES).

Retrospective study. The unit of analysis was the patient attended at the HES.

Xàtiva Hospital records and data from Primary Care Management, regarding the type of ECPC and the distance from the patient's town of residence to the hospital.

The data of all the patients, a total of 15,290 cases, attended at the HES during the first six months of 1992 were analysed.

We constructed a logistic regression model whose explicative variables were the type of ECPC and the distance to the hospital. The variable reply was the probability for each town of causing a high use of HES. We obtained a model whose predictive capacity was 82.98%, in which, independently of distance, the probability of causing a high use of HES was ordered from low to high, as follows: 1) Towns where the Primary Care Team (PCT) physically provided ongoing care in the town itself. 2) Towns attended by a normal Emergency Service (in the town itself). 3) Towns where the PCT provided ongoing care of a localised nature. 4) Towns where the PCT physically provided ongoing care in another town. The relation of distance to the use of HES was inverse.

Distance and the different types of ECPC affect the use of HES.