title: Self-rated health and hospital services use in the Spanish National Health System: a longitudinal study.
abstract: BACKGROUND
  Self-rated health is a subjective measure that has been related to indicators such as mortality, morbidity, functional capacity, and the use of health services. In Spain, there are few longitudinal studies associating self-rated health with hospital services use. The purpose of this study is to analyze the association between self-rated health and socioeconomic, demographic, and health variables, and the use of hospital services among the general population in the Region of Valencia, Spain.
  
  
  METHODS
  Longitudinal study of 5,275 adults who were included in the 2005 Region of Valencia Health Survey and linked to the Minimum Hospital Data Set between 2006 and 2009. Logistic regression models were used to calculate the odds ratios between use of hospital services and self-rated health, sex, age, educational level, employment status, income, country of birth, chronic conditions, disability and previous use of hospital services.
  
  
  RESULTS
  By the end of a 4-year follow-up period, 1,184 participants (22.4%) had used hospital services. Use of hospital services was associated with poor self-rated health among both men and women. In men, it was also associated with unemployment, low income, and the presence of a chronic disease. In women, it was associated with low educational level, the presence of a disability, previous hospital services use, and the presence of chronic disease. Interactions were detected between self-rated health and chronic disease in men and between self-rated health and educational level in women.
  
  
  CONCLUSIONS
  Self-rated health acts as a predictor of hospital services use. Various health and socioeconomic variables provide additional predictive capacity. Interactions were detected between self-rated health and other variables that may reflect different complex predictive models, by gender.
authors.affiliation: Department of Community Nursing, Research Unit for the Analysis of Mortality and Health Statistics, Preventive Medicine, Public Health and History of Science. University of Alicante. Campus de San Vicente del Raspeig s/n, Apartado 99, 03080, Alicante, Spain. nayara.tamayo@ua.es.
authors.forename: Nayara
authors.initials: N
authors.lastname: Tamayo-Fonseca
authors.affiliation: Department of Community Nursing, Research Unit for the Analysis of Mortality and Health Statistics, Preventive Medicine, Public Health and History of Science. University of Alicante. Campus de San Vicente del Raspeig s/n, Apartado 99, 03080, Alicante, Spain. nolasco@ua.es.
authors.forename: Andreu
authors.initials: A
authors.lastname: Nolasco
authors.affiliation: Department of Community Nursing, Research Unit for the Analysis of Mortality and Health Statistics, Preventive Medicine, Public Health and History of Science. University of Alicante. Campus de San Vicente del Raspeig s/n, Apartado 99, 03080, Alicante, Spain. ja.quesada@ua.es.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Quesada
authors.affiliation: Department of Community Nursing, Research Unit for the Analysis of Mortality and Health Statistics, Preventive Medicine, Public Health and History of Science. University of Alicante. Campus de San Vicente del Raspeig s/n, Apartado 99, 03080, Alicante, Spain. pamela.pereyra@ua.es.
authors.forename: Pamela
authors.initials: P
authors.lastname: Pereyra-Zamora
authors.affiliation: Department of Community Nursing, Research Unit for the Analysis of Mortality and Health Statistics, Preventive Medicine, Public Health and History of Science. University of Alicante. Campus de San Vicente del Raspeig s/n, Apartado 99, 03080, Alicante, Spain. melchor_inm@gva.es.|Registro de Mortalidad de la Comunidad Valenciana, Servicio de Estudios Epidemiológicos y Estadísticas Sanitarias. Subdirección General de Epidemiología y Vigilancia de la Salud. Conselleria de Sanitat, Plaza de España 6, 03010, Alicante, Spain. melchor_inm@gva.es.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Melchor
authors.affiliation: Department of Community Nursing, Research Unit for the Analysis of Mortality and Health Statistics, Preventive Medicine, Public Health and History of Science. University of Alicante. Campus de San Vicente del Raspeig s/n, Apartado 99, 03080, Alicante, Spain. joaquin.moncho@ua.es.
authors.forename: Joaquin
authors.initials: J
authors.lastname: Moncho
authors.affiliation: Servicio de Análisis de Sistemas de Información Sanitaria, Conselleria de Sanitat, Generalitat Valenciana. C/Micer Mascó, 31-33, 46010, Valencia, Spain. calabuig_jul@gva.es.
authors.forename: Julia
authors.initials: J
authors.lastname: Calabuig
authors.affiliation: Servicio del Plan de Salud, Dirección General de Salud Pública. Conselleria de Sanitat, Generalitat Valenciana. Avda. Cataluña, 21, 46020, Valencia, Spain. barona_car@gva.es.
authors.forename: Carmen
authors.initials: C
authors.lastname: Barona
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004651:Employment; D005260:Female; D006078:Government Programs; D006304:Health Status; D006306:Health Surveys; D006761:Hospitals / Q000592:standards* / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008483:Medical Assistance; D008875:Middle Aged; D016017:Odds Ratio; D011203:Poverty; D057566:Self Report; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology; D055815:Young Adult