[Organizational characteristics of primary care and hospitalization for to the main ambulatory care sensitive conditions].
OBJECTIVE
To describe the variability in hospitalisation rates because of the most common ambulatory care sensitive conditions (ACSC), by town and gender; b) to describe the influence on these rates of the characteristics of primary care (reformed or non-reformed model and kind of centre), the health level of the population, geographical accessibility and other factors of a social and economic nature.


METHODS
Observational, cross-sectional study of hospital discharges and ecological study for the analysis of rates between towns.


METHODS
The rates of hospitalisation by gender for each ACSC (1997-1999), standardised for age through the indirect method by calculating the standardised rate ratios (SRR). The multivariate analysis used Poisson regression.


RESULTS
In the diagnoses studied, 41% of the towns had the same number of cases observed and expected for hospitalisation of men; and 65%, for women. Chronic obstructive pulmonary disease in men and heart failure in women were the illnesses that most varied. Hospitalisation rates for most illnesses were higher in towns without a health centre or with a non-reformed model, with over 3000 inhabitants and closer to hospital, although distance from the hospital was an influential factor only in bigger towns.


CONCLUSIONS
There is variability between towns in hospitalisation rates for the most common ACSC; b) the differences in hospitalisation rates for the ACSC studied are linked to organisational features of primary care, the size of the town and the distance from the hospital.
Bermúdez-Tamayo
C
C
Escuela Andaluza de Salud Pública, Granada, España. clara.bermudez.eas@juntadeandalucia.es
Márquez-Calderón
S
S
Rodríguez del Aguila
M M
MM
Perea-Milla López
E
E
Ortiz Espinosa
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003953:Diagnosis-Related Groups; D005260:Female; D006302:Health Services Research; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011320:Primary Health Care / Q000706:statistics & numerical data*; D017678:Sex Distribution; D013030:Spain