After hours healthcare for older patients in New Zealand

To explore patterns of general practice after hours service use in different age groups, and to identify possible reasons for any differences between older and younger people in their use of after hours services.

Attendance data from two after hours clinics (AHCs) and the local hospital emergency department (ED) for 2002 were collected and analysed statistically.

Older people, especially the "young-old" (aged 65 to 74) used after hours health centres at a lower rate than younger adults. Older people attended the ED at a higher rate than younger adults, except for the "young-old" who attended at a similar rate. European ethnicity, symptoms resulting from an accident, and increasing severity of the illness were positively correlated with ED attendance.

Older people presented to after hours clinics less than would be expected, especially given their greater morbidity. Older people attended the Hutt Valley ED after hours at a higher rate than younger people, but at a lower rate than in normal hours. Older people were sicker on arrival at ED (especially after hours) than younger people. These results have implications for service delivery and also equity issues as they affect older people.