OBJECTIVES: To analyse the causes and financial implications on the variability of use of A&E resources (visits, admissions) across Spanish Hospitals and Regions METHODS: Review of the Configuration Management DataBase Set (CMDB) and Hospital Discharge Statistics during the period 2010-2012, using a multivariate analyses controlling for factors like: region, sex, age, income, etc...to explain the relative rate to average and variations within and between regions. RESULTS: There is a significant variation between and within regions and hospitals, which is mostly explained by personal income, distance to hospitals, availability of alternatives in Primary Care, and, quite interestingly (p<0.05 within Hospitals of same regions), size of hospital measured in terms of available beds. This impacts on the resource allocation, new hospitals to be erected -new investments- and cost per patient. CONCLUSIONS: Variability of A&E resource utilisation (frequency of visits, hospitalizations) is greatly explained using a multidimensional approach within and betwen regions, having more than 80% explanative variables laying into Personal Income, Distance to Hospital, Available Beds, and Primary Care Ambulatory alternatives. Other variables were not deemed to be significant.