[Differences in hospital utilization between the autonomous communities of Madrid and Catalonia]

Regional differences in hospital utilization have been long recognized. The objective of this study is to find out differences in hospital utilization and structure between Madrid and Catalonia. We calculate the crude and adjusted discharge and bed days rates and average length of stay from 1987 through 1989 for all diagnoses, and for 30 selected diagnoses by province of residence in 1987. We obtained the located and allocated beds, and the distribution of discharges by payers and of beds by providers for both regions, Catalonia shows consistently higher discharge rates (40% of public beds and 3.70 used beds) and Madrid has longer hospital stays (70% of public beds and 3.98 used beds). This work allows to formulate two questions about how health services operate: 1) organizational aspects could affect medical behavior. 2) hospital bed days could depend more on discharge rates than on length of stay.