title: [Use of emergency departments in rural and urban areas in Spain].
abstract: OBJECTIVE
  Describe the use of emergency departments (ED), and analyse the differences in use between residents in rural and urban areas.
  
  
  METHODS
  Using data from the National Health Survey of 2006 and 2011, the profiles of patients with ED visits by population size of place of residence were obtained. The variables associated with making one visit to the ED were also evaluated, in order to determine the effect of the population size of place of residence.
  
  
  RESULTS
  A higher use of ED is observed in persons with a higher frequency of use of Primary Care and hospital admissions, and increases with worse self-perceived health and functional status, with more chronic diseases, in people from lower social classes, and younger ages. Adjusting for the other variables, residents in larger cities have a higher use of ED than residents in rural areas, who show a higher use of public and non-hospital based ED, than residents in urban areas.
  
  
  CONCLUSIONS
  There is a higher use of ED by inhabitants of urban areas that cannot be justified by a worst health status of that population. This tends to indicate that the use of ED is not under-used in rural areas, but overused in urban areas.
authors.affiliation: Agencia de Evaluación de Tecnologías Sanitarias, Instituto de Salud Carlos III, Madrid, España; Unidad Docente de Medicina Preventiva y Salud Pública, Universidad de Alcalá, Alcalá de Henares, Madrid, España; Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC). Electronic address: asarria@isciii.es.
authors.forename: A
authors.initials: A
authors.lastname: Sarría-Santamera
authors.affiliation: Agencia de Evaluación de Tecnologías Sanitarias, Instituto de Salud Carlos III, Madrid, España.
authors.forename: J
authors.initials: J
authors.lastname: Prado-Galbarro
authors.affiliation: Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC); Servicio de Evaluación y Planificación. Servicio Canario de Salud, Santa Cruz de Tenerife, España.
authors.forename: Y
authors.initials: Y
authors.lastname: Ramallo-Farina
authors.affiliation: Servicio de Urgencias, Hospital La Paz, Madrid, España; Departamento de Medicina, Universidad Autónoma de Madrid, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Quintana-Díaz
authors.affiliation: Servicio de Urgencias, Hospital La Paz, Madrid, España.
authors.forename: A
authors.initials: A
authors.lastname: Martínez-Virto
authors.affiliation: Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC); Servicio de Evaluación y Planificación. Servicio Canario de Salud, Santa Cruz de Tenerife, España.
authors.forename: P
authors.initials: P
authors.lastname: Serrano-Aguilar
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D019035:Rural Health Services / Q000706:statistics & numerical data*; D013030:Spain; D019037:Urban Health Services / Q000706:statistics & numerical data*
keywords: Emergency department; Medio rural; Medio urbano; Planificación; Planning; Rural areas; Servicios de urgencia; Urban areas; Use; Utilización