Out-of-hours utilization in primary and secondary care. A favourable experience in a finnish health centre

Abstract

Objective - To clarify whether out-of-hours health centre visits and referrals to hospital are equally distributed in the three different duty models being used for health care in southwestern Finland. Design - A medical audit of 2926 health centre visits and 223 referrals to hospitals by general practitioners (GPs) on duty. The duty models were formed on the basis of a possibility to utilize a local health centre during nights and weekends. Two- month follow-up period. Setting - Primary health care. Population 46438. Main outcome measures - Out-of-hours visits to health centres and referrals to hospital, and the effect of age and duty model on referrals and visits. Results - Patients over 64 years of age received most of the referrals although they visited the health care centre less frequently than the 0-14 year-olds (p < 0.001). The people who had an opportunity to utilize their local health centres visited more during out-of-hours than those who did not have this opportunity (p < 0.001). Conclusions - The health centre visits were not equally distributed in the three examined duty models. The over 64 year-olds in particular had the least visits and the most referrals.