Hospital and primary care emergency services in Asturias [Spain: variations among health areas and trends between 1994-2001

To describe primary care and hospital emergency utilization rates in Asturias health districts from 1994 to 2001 and to analyse their variability. Hospital and primary care rates from 1994 to 2001 in the 8 Asturias health districts were estimated. Their variability was analysed using indirect standardisation and small area variation statistics. Almost 6.5 million of emergencies (hospitals: 43.8%) were attended in Asturias from 1994 to 2001. The average annual growth was 6.2% (primary care: 7.8%; hospitals: 5.1%) with differences among districts. Primary care variability was higher (variation coefficient: 0.38 and 0.27 in 1994 and 2001) than hospital variability (variation coefficient: 0.14 and 0.11) and it decreased in the period. Emergency Health Services utilization growth between 1994 and 2001, with strong variability among health districts.