title: Service use of older people who participate in primary care health promotion: a latent class analysis.
abstract: Recruiting patients to health promotion programmes who will benefit is crucial to success. A key policy driver for health promotion in older people is to reduce health and social care use. Our aim was to describe service use among older people taking part in the Multi-dimensional Risk Appraisal for Older people primary care health promotion programme.
  
  
  
  A random sample of 1 in 3 older people (≥65 years old) was invited to participate in the Multi-dimensional Risk Appraisal for Older people project across five general practices in London and Hertfordshire. Data collected included socio-demographic characteristics, well-being and functional ability, lifestyle factors and service use. Latent class analysis (LCA) was used to identify groups based on use of the following: secondary health care, primary health care, community health care, paid care, unpaid care, leisure and local authority resources. Differences in group characteristics were assessed using univariate logistic regression, weighted by probability of class assignation and clustered by GP practice.
  
  
  
  Response rate was 34% (526/1550) with 447 participants presenting sufficient data for analysis. LCA using three groups gave the most meaningful interpretation and best model fit. About a third (active well) were fit and active with low service use. Just under a third (high NHS users) had high impairments with high primary, secondary and community health care contact, but low non-health services use. Just over a third (community service users) with high impairments used community health and other services without much hospital use.
  
  
  
  Older people taking part in the Multi-dimensional Risk Appraisal for Older people primary care health promotion can be described as three groups: active well, high NHS users, and community service users.
authors.affiliation: Department of Public Health and Primary Care, Norwich Medical School, University of East Anglia, Norwich, UK.
authors.forename: John A
authors.initials: JA
authors.lastname: Ford
authors.affiliation: Department of Primary Care and Population Health, University College London, Royal Free Campus Rowland Hill St, London, NW3 2PF, UK.
authors.forename: Kalpa
authors.initials: K
authors.lastname: Kharicha
authors.affiliation: Department of Primary Care and Population Health, University College London, Royal Free Campus Rowland Hill St, London, NW3 2PF, UK.
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Clarke
authors.affiliation: Department of Public Health and Primary Care, Norwich Medical School, University of East Anglia, Norwich, UK.
authors.forename: Allan
authors.initials: A
authors.lastname: Clark
authors.affiliation: Department of Primary Care and Population Health, University College London, Royal Free Campus Rowland Hill St, London, NW3 2PF, UK.
authors.forename: Steve
authors.initials: S
authors.lastname: Iliffe
authors.affiliation: Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: Goodman
authors.affiliation: Social Care Workforce Research Unit, King's College London, London, UK.
authors.forename: Jill
authors.initials: J
authors.lastname: Manthorpe
authors.affiliation: Department of Public Health and Primary Care, Norwich Medical School, University of East Anglia, Norwich, UK.
authors.forename: Nick
authors.initials: N
authors.lastname: Steel
authors.affiliation: Department of Primary Care and Population Health, University College London, Royal Free Campus Rowland Hill St, London, NW3 2PF, UK. k.walters@ucl.ac.uk.
authors.forename: Kate
authors.initials: K
authors.lastname: Walters
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data; D006293:Health Promotion / Q000379:methods*; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008131:London; D008297:Male; D011320:Primary Health Care / Q000706:statistics & numerical data*
keywords: Health promotion; Health services for the aged; Primary health care