title: Differences in access points to the ambulatory health care system across Austrian federal states.
abstract: BACKGROUND
  The nine Austrian regions differ according to demographic parameter, health status, and health care structure. It was the aim of this study to analyse whether there are also differences in access points towards the level of ambulatory care.
  
  
  METHODS
  The Austrian Health Interview Survey (2006-2007) data with 15,474 participants were used for this cross-sectional analysis. Statistical analyses included descriptive statistics as well as multivariate logistic regression models and correlations.
  
  
  RESULTS
  There were significant differences in patients with direct utilisation of specialists without having consulted a general practitioner (GP) in the same period in the Austrian regions, with highest proportions for women in Vorarlberg (20.3%) and men in Vienna (21.5%) and lowest in Burgenland (7.0 and 6.6%, respectively). The specialist/GP ratio correlated significantly with the direct specialist utilisation (Spearman correlation coefficient: 0.717).
  
  
  CONCLUSIONS
  There are spatial differences in the health care utilisation within the Austrian regions, which partly can be explained by the disposal of health care structure. These findings are of special importance according to the ongoing debate concerning the topic strengthening the primary health care sector in Austria.
authors.affiliation: Department of General Practice and Family Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1st floor, 1090, Vienna, Austria, kathryn.hoffmann@meduniwien.ac.at.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Hoffmann
authors.forename: Katharina Viktoria
authors.initials: KV
authors.lastname: Stein
authors.forename: Thomas Ernst
authors.initials: TE
authors.lastname: Dorner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001317:Austria; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006302:Health Services Research / Q000706:statistics & numerical data; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008511:Medicine / Q000706:statistics & numerical data; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014600:Utilization Review / Q000706:statistics & numerical data; D055815:Young Adult