After-hours medical deputising services: patterns of use by older people.
OBJECTIVE
To examine how older people use an after-hours medical deputising service that arranges home visits by locum general practitioners; to identify differences in how people who live in the community and those who live in residential aged care facilities (RACFs) use this service.


METHODS
Retrospective analysis of routinely collected administrative data from the Melbourne Medical Deputising Service (MMDS) for the 5-year period, 1 January 2008 - 31 December 2012. Data for older people (≥ 70 years old) residing in greater Melbourne and surrounding areas were analysed.


METHODS
Numbers and rates of MMDS bookings for acute after-hours care, stratified according to living arrangements (RACF v community-dwelling residents).


RESULTS
Of the 357 112 bookings logged for older patients during 2008-2012, 81% were for RACF patients, a disproportionate use of the service compared with that by older people dwelling in the community. Most MMDS bookings resulted in a locum GP visiting the patient. During 2008-2012, the booking rate for RACFs increased from 121 to 168 per 1000 people aged 70 years or more, a 39% increase; the booking rate for people not living in RACFs increased from 33 to 40 per 1000 people aged 70 years or more, a 21% increase.


CONCLUSIONS
After-hours locum GPs booked through the MMDS mainly attended patients living in RACFs during 2008-2012. Further research is required to determine the reasons for differences in the use of locum services by older people living in RACFs and in the community.
Monash University, Melbourne, VIC danielle.mazza@monash.edu.
Angela
A
Joe
Monash University, Melbourne, VIC.
Judy A
JA
Lowthian
Gippsland Primary Health Network, Moe, VIC.
Marianne
M
Shearer
Monash University, Melbourne, VIC.
Lyle R
LR
Turner
Monash University, Melbourne, VIC.
Bianca
B
Brijnath
Monash University, Melbourne, VIC.
Christopher
C
Pearce
Monash University, Melbourne, VIC.
Colette
C
Browning
Monash University, Melbourne, VIC.
Danielle
D
Mazza
D039602:After-Hours Care / Q000458:organization & administration*; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001315:Australia; D003284:Contract Services / Q000458:organization & administration*; D005260:Female; D006299:Health Services for the Aged / Q000458:organization & administration*; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D011320:Primary Health Care / Q000458:organization & administration; D011787:Quality of Health Care; D012189:Retrospective Studies