Estimation of the real population and its impact on the utilisation of healthcare services in Mediterranean resort regions: an ecological study.
BACKGROUND
The demographic structure has a significant influence on the use of healthcare services, as does the size of the population denominators. Very few studies have been published on methods for estimating the real population such as tourist resorts. The lack of information about these problems means there is a corresponding lack of information about the behaviour of populational denominators (the floating population or tourist load) and the effect of this on the use of healthcare services. The objectives of the study were: a) To determine the Municipal Solid Waste (MSW) ratio, per person per day, among populations of known size; b) to estimate, by means of this ratio, the real population in an area where tourist numbers are very significant; and c) to determine the impact on the utilisation of hospital emergency healthcare services of the registered population, in comparison to the non-resident population, in two areas where tourist numbers are very significant.


METHODS
An ecological study design was employed. We analysed the Healthcare Districts of the Costa del Sol and the island of Menorca. Both are Spanish territories in the Mediterranean region.


RESULTS
In the two areas analysed, the correlation coefficient between the MSW ratio and admissions to hospital emergency departments exceeded 0.9, with p < 0.001. On the basis of MSW generation ratios, obtained for a control zone and also measured in neighbouring countries, we estimated the real population. For the summer months, when tourist activity is greatest and demand for emergency healthcare at hospitals is highest, this value was found to be double that of the registered population.


CONCLUSIONS
The MSW indicator, which is both ecological and indirect, can be used to estimate the real population in areas where population levels vary significantly during the year. This parameter is of interest in planning and dimensioning the provision of healthcare services.
Perea-Milla
Emilio
E
Unidad de Apoyo a la Investigación, Evaluación y Contabilidad (Red IRYSS), Hospital Costa del Sol, Ctra Nacional 340, km 187, 29600 Marbella, Spain. eperea@hcs.es
Pons
Sergi Mari
SM
Rivas-Ruiz
Francisco
F
Gallofre
Anna
A
Jurado
Enrique Navarro
EN
Ales
Marco A Navarro
MA
Jimenez-Puente
Alberto
A
Fernandez-Nieto
Fidel
F
Cerda
Joan C March
JC
Carrasco
Manuel
M
Martin
Lydia
L
Cano
Damian Lopez
DL
Gutierrez
Gonzalo E
GE
Macías
Rafael Cortes
RC
Garcia-Ruiz
Jose A
JA
D000328:Adult; D017677:Age Distribution; D000368:Aged; D004463:Ecology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000208:ethnology; D006294:Health Resorts / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D019083:Mediterranean Region / Q000453:epidemiology; D008875:Middle Aged; D011157:Population Dynamics; D012537:Scandinavian and Nordic Countries / Q000208:ethnology; D012621:Seasons; D017678:Sex Distribution; D013030:Spain / Q000453:epidemiology; D014195:Travel / Q000706:statistics & numerical data*; D006113:United Kingdom / Q000208:ethnology; D014600:Utilization Review; D018505:Waste Management / Q000706:statistics & numerical data*