Development of office-hours use of primary health centers in the early years of the 21(st) century: a 13-year longitudinal follow-up study

This study, conducted in a Finnish city, examined whether a long-lasting observed trend in Finnish primary health care, namely, a decreasing rate of office-hour visits to general practitioners (GPs), would lead to reduced services for specific gender, diagnosis or age groups. This was an observational retrospective follow-up study. The annual number of visits to office-hour primary care GPs in different gender, diagnosis and age groups was recorded during a 13-year follow-up period. The effect of the decreasing visit rate on the annual mortality rate in different age and gender groups was also studied. The total number of monthly visits to office-hour GPs decreased slowly over the whole study period. This decrease was stronger in women and older people. The proportion of recorded infectious diseases (Groups A and J and especially diagnoses related to infections of respiratory airways) decreased. Proportions of recorded chronic diseases increased (Group I, cardiovascular diseases, diabetes and osteoarthrosis) during the follow-up. The annual rate of visits to office-hour GP/per GP decreased. There was a decrease in the mortality in two of the age groups (20-64, 65+ years) and no change in the youngest population (0-19 years). The decrease in the office-hours GP activity does not seem to increase mortality either.