Our hypothesis that residents of sparsely-settled communities are prepared to travel significantly further to access a GP for non-emergency utilisation compared with residents of closely-settled rural communities was confirmed.
The finding that IHIC also showed greater emergency services utilisation department use suggests that the cause lies in overcoming barriers to access rather than in immigrants' socioeconomic position.
Although this study cannot prove the impact of a better accessible primary health care system on emergency care utilisation rates or on secondary care utilisation rates, a recent study commissioned by the Belgian government gives an important indicator of the possible impact.
However, in agreement with most studies using other approaches and not adjusting by the reference population [ 5, 27- 32], our finding of lower emergency department utilisation by immigrants suggests overall lower healthcare use in this population.
This is consistent with high primary care and emergency department utilisation seen among homeless populations.
Spanish legislation ensures emergency room utilisation to everyone, regardless of origin, nationality or legal status [ 6].
59 What makes PCMH a policy imperative is the anticipation that emergency room utilisation will fall and hospital readmissions will decrease.
We aimed to compare emergency department utilisation rates between Spanish-born and foreign-born residents in a public hospital of Barcelona.
However, the number of patients identified with no prior emergency inpatient utilisation in the previous 2 years was relatively small across all models.
Thus, the purpose of this study was to assess hospital emergency department utilisation among registered Spanish-born and foreign-born adults in Barcelona in 2004.
The proportions of single-handed practices, GPs older than sixty, or practices with female partners, were strongly associated with patterns of emergency hospital utilisation but only weakly or not associated with mortality or the proportion of teenage conceptions.
