171 cases consecutively seen in a hospital emergency service were prospectively evaluated. Several data were recorded to assess the type of care given and the need for attention in an institution with the technical resources of a hospital. These data were evaluated considering whether the user had moved from another town to receive attention and whether he had been referred by a physician or not. There were definite differences in the behavior of the user from the town where the hospital is located and the remaining users. These differences were not attributable to a different performance or evaluation from the primary care services of the several towns involved. It was concluded that, at the present time, the use of the emergency service of our hospital is significantly influenced by the decision of the user to consult the service. Factors other than the severity of the disease influence this decision.