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

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.