HOSPITALIZATIONS OF CHILDREN AND ACCESS TO PRIMARY-CARE - A CROSS-NATIONAL COMPARISON

In the United States, hospital admissions for conditions sensitive to primary care are related to socioeconomic characteristics. The authors compare the prevalence of avoidable hospital admissions and their rel ationship to socioeconomic and primary care characteristics in Spain a nd the United States. A case-control analysis of the relationship betw een avoidable hospitalizations and socioeconomic characteristics (illi teracy, unemployment, income) and primary care characteristics (type o f physician and facilities for primary care) of children's area of res idence was conducted in Spain. Bivariate statistical tests and conditi onal logistic regression were used to test the strength of the associa tion among the variables, and to calculate the probability of being ad mitted to hospital for treatment of an ambulatory care sensitive (ACS) condition. Neither socioeconomic nor primary care characteristics aff ected this probability, and the rate of admission for ACS conditions w as lower in Spain than in the United States. The provision of universa l financial access to care and the availability of a consistent and ac countable primary care provider are associated with lower hospitalizat ion rates for conditions that are preventable with good primary care.