Journal Information
Vol. 7. Issue 35.
Pages 63-69 (March - April 1993)
Vol. 7. Issue 35.
Pages 63-69 (March - April 1993)
Open Access
Diferencias Regionales en la Utilización Hospitalaria
Regional Differences In Hospital Utilization
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Antonio Sarría Santamera*, Juan Manuel Sendra Gutiérrez
Subdirección General de Epidemiología. Ministerio de Sanidad y Consumo
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Resumen

Numerosos estudios vienen demostrando grandes diferencias en la utilización hospitalaria entre regiones. El objetivo del presente trabajo es estudiar la variación de las tasas de hospitalización en España entre las 17 Comunidades Autónomas en 1988. Se calculan a partir de la Encuesta de Morbilidad Hospitalaria, la tasa de frecuentación hospitalaria global y específica para 14 diagnósticos. De estas tasas se obtiene el coeficiente de variación, la razón de variación y el componente sistemático de variación que presenta un valor mínimo de 0,96 para las hernias y un valor máximo de 8,45 para lasvarices. Se encuentran importantes variacionesque son consistentes con las de estudios realizados en países con sistemas sanitarios muy diferentes. Aunque se deben implantar sistemas de información que permitan realizar estudios poblacionales, estas variaciones son demasiado grandes para ignorarlas, reflejan desigualdades y hay que tenerlas en cuenta en la planificación.

Palabras clave:
Morbilidad hospitalaria
Utilización de hospitales.
Summary

Many recent studies have demonstrated that hospital utilization rates vary widely among similiar areas and regions. The objective of this study is to find out the variation among the hospitalización rates in Spain across the 17 Autonomic Communities in 1988. From the Hospital Morbidity Survey we calculate the general discharge rate and the rate for 14 diagnostics. To evaluate the degree of variation we calculate the coefficient of variation, the extremal quotient and the systematic component of variation, which ranges from 0,96 (hernia) to 8.45 (varicose veins). This substantial variations are consistent with studies performed in countries with different health systems. Although new information systems which allow to perform population based studies are due to establish, these variations are too large to ignore and have to be taken account in policy making.

Keywords:
Hospital morbidity
Hospital utilization.
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Biblografía
[1.]
M.R. Chassin, R.H. Brook, R.E. Park, et al.
Variations in the use of medical and surgical services by the medicare population.
N Eng J Med, 315 (1986), pp. 285-290
[2.]
J.D. Clark.
Variation in Michigan hospital use rates: do physician and hospital characteristics provide the explanation?.
Soc Sci Med, 30 (1990), pp. 67-82
[3.]
J.R. Knickman, A.M. Foltz.
Regional differences in hospital utilization. How much can be traced to population differences?.
Med Care, 22 (1984), pp. 971-986
[4.]
M.W. Legnini, J.D. Thompson, R. DerSimonian, J.T. Lynch.
changes in Connecticut hospital use rates: have small-area variations been affected?.
Inquiry, 27 (1990), pp. 51-60
[5.]
C.G. MacLaughlin, D.P. Normolle, R.A. Wolfe, L.F. McMahon, J.R. Griffith.
Small-Area variation in hospital discharge rates.
Med Care, 27 (1989), pp. 507-521
[6.]
K. McPherson, J.E. Wennberg, O.B. Hovind, P. Clifford.
Small-Area variations in the use of common surgical procedures: an international comparison of New England, England and Norway.
N Eng J Med, 307 (1982), pp. 1310-1314
[7.]
Small Area Variation Advisory Committee.
Variations in the use of medical and surgical services by the Maryland population.
[8.]
J.E. Wennberg, J.L. Freeman, W.J. Culp.
Are hospital services rationed in New Haven or over-utilised in Boston?.
Lancet, 1 (1987), pp. 1185-1189
[9.]
J.E. Wennberg, J.L. Freeman, R.M. Shelton, T.A. Bubolz.
Hospital use and mortality among medicare beneficiaries in Boston and New Haven.
N Eng J Med, 321 (1989), pp. 1168-1173
[10.]
J. Wennberg, A. Gittelsohn.
Small area variations in health care delivery.
Science, 182 (1973), pp. 1102-1108
[11.]
J. Wennberg, A. Gittelsohn.
Variations in Medical Care among small areas.
Sci Am, 246 (1982), pp. 120-134
[12.]
P. Paul-Shaheen, J.D. Clark, D. Williams.
Small area analysis: a review and analysis of the North American literature.
Journal of Health Politics, Policy and Law, 12 (1987), pp. 741-809
[13.]
M. Stano.
Further issues in small area variations analysis.
Journal of Health Politics, Policy and Law, 16 (1991), pp. 573-588
[14.]
J.I. Cuervo.
¿Cómo discutir las propuestas de gestión del Informe Abril Martorell?.
Gestión Sanitaria, 20 (1992), pp. 2-3
[15.]
N. Sanfrutos.
La financiación de los servicios regionales de salud. Problemas y posibles soluciones.
Gac Sanit, 5 (1991), pp. 219-224
[16.]
B. Kirkup, D. Forster.
How will health needs be measured in districts? Implications of variations in hospital use.
J Pubi Health Med, 12 (1990), pp. 45-50
[17.]
Regional Committee for Europe.
Revised list of indicators and procedure for monitoring progress health for all in the European region (1987–1988).
[18.]
Instituto Nacional de Estadística.
Encuesta de Morbilidad Hospitalaria año 1988.
¿, (1990),
[19.]
Estimaciones de poblaciones realizadas por el Centro de Cálculo del Ministerio de Sanidad y Consumo en base a los censos de población de 1960, 1970 y 1981
[20.]
E.S. Fisher, H.G. Welch, J.E. Wennberg.
Prioritizing Oregon’s Hospital Resources.
JAMA, 267 (1992), pp. 1925-1931
[21.]
M.I. Roemer.
Bed supply and hospital utilization: a natural experiment.
Hospitals, JAHA, 35 (1961), pp. 36-43
[22.]
P. Diehr, K. Cain, F. Connell, E. Volinn.
What is too much variation? The null hypothesis in small-area analysis.
Health Serv Res, 24 (1990), pp. 741-771
[23.]
F. García Benevides, A. Alen Fidalgo, C. Escandón Moret.
Estadísticas de morbilidad hospitalaria: cumplimentación del Libro de Registro.
Gac Sanit, 1 (1987), pp. 49-52
[24.]
S. Shapiro.
Epidemiology and Public Policy.
Am J Epidemiol, 134 (1991), pp. 1057-1061
[25.]
P. Caper.
Data-based strategies for the management of medical decision making.
The economics of health care: challenges for the nineties, pp. 14-21
[26.]
Ministerio de Sanidad y Consumo.
Indicadores de salud.
2a ed,
[27.]
R.A. Carr-Hill, A. Maynard, R. Slack.
Morbidity variation and RAWP.
J Epidemiol Commun Health, 44 (1990), pp. 271-273
Copyright © 1993. Sociedad Española de Salud Pública y Administración Sanitaria
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