[An exploration of factors that influence the frequency of the use of hospital emergency services and admissions]. / Exploración de algunos factores que influyen en la frecuentación a urgencias del hospital y su ingreso.

OBJECTIVE: To examine how some factors connected with Continuous Care Points (CCP) affect attendance at hospital Casualty departments and admittance from them. DESIGN: Ecological study. SETTING: León Health area. PATIENTS AND OTHER PARTICIPANTS: All the CCP's belonging to the León Health area. MEASUREMENTS AND MAIN RESULTS: Average attendance at hospital Casualties was 15.7 per 1,000 inhabitants per month. Those patients who brought with them a P10 form were more likely to be admitted (39.5% to 26.5%) than those who did not bring this form (p < 0.01). It was concluded from a regression analysis that the distance between the CCP and the hospital decisively affects attendance at hospital Casualties (r = -0.74) and that the admission rate is positively related to distance (r = 0.72) and negatively to the said attendance at Casualties (r = -0.77). CONCLUSION: Use of hospital Casualty departments increases as accessibility (distance) improves. Distance and the ageing of the population are factors which have an important effect on the admission rates from Casualties.

[An epidemiological and clinical study of malignant cutaneous melanoma in the catchment area of León]. / Estudio epidemiológico y clínico del melanoma maligno cutáneo en el área sanitaria de León.

BACKGROUND: During the last decade the incidence of cutaneous malignant melanoma (CMM) has increased in different geographic areas around the world. The aim of this study is to know the incidence and clinical characteristics of CMM in the area of Leon between 1980-1989. METHODS: One hundred nineteen cases corresponding to the total CMM cases diagnosed over the aforementioned period were reviewed. Clinical characteristics were studied and the annual and five-year incidence were calculated. Results were compared between two five year period (1980-1984 and 1985-1989). RESULTS: The mean annual incidence rose from 1.9 in the first five year period to 4.4 cases per one hundred thousand cases per year in the second period (p less than 0.01). Furthermore, in this period a diminution was observed in the diagnosis of CMM with an elevated Clark level (III-V), with an increase of the lowest levels (p less than 0.05). There was a high predominance of women (76%) which increased in the second five year period (p less than 0.05). The mean age was 61.7 years which was higher than that reported by other authors with the most frequent sites being: head-neck (40%) and trunk (25%) The predominant histology was melanoma of superficial spread (46%). These variables did not vary significantly throughout the period studied.