OBJECTIVES: To describe health care resource consumption and subsequent costs in GERD management in primary care centers in Spain. METHODS: In this retrospective, observational study, a random sample of all patients who visited a primary health care center in Spain for a reason related to GERD over a 4 months period were included. Patients with GERD symptoms were invited to participate, and those who accepted completed an interview visit during which clinical data were collected. Information regarding health care resources (diagnostic methods, physicians visits and hospitalization days) during the time between the two visits was collected, transformed into annual consumption, and expressed as 2008 € (according to public tariffs available and rate of inflation). RESULTS: Overall, 63,416 patients were identified during the study period. In 1727 (2.7%) patients GERD was a reason for the visit. Of these, 579 patients were randomly selected and 87% participated in the study; Mean age was 60 years (SD: 15,7), 59% were women. Patients with a high symptom load (frequency: ³2 days or daily; and intensity: moderate or severe), made a mean number of visits per year to a PCP of 5.35 compared with 2.2 visits in patients with a low symptom load; visits to a gastroenterologist were 1.55 vs. 0.45 and to other specialists were 0.64 vs. 0.17, with hospitalization days 0.61 vs. 0, respectively. Total direct medical costs increased on average from €186€ to €578€ to €956 when patient-reported heartburn intensity varied from mild to moderate to severe, respectively; and from €314 to 623€ to €1076 when acid regurgitation was also considered. CONCLUSIONS: Higher symptom load at baseline leads to an increasing use of health care resource. Further research is needed to better understand the causes as well as identifying potential GERD management approaches that could better optimize health care resource utilization.