Rural and Remote Health Journal photo
African section Asian section European section International section Latin American section North American section
current articles
information for authors
status/user profile
about us

Original Research

Sharing after hours care in a rural New Zealand community – a service utilization survey

Submitted: 5 June 2008
Revised: 4 September 2008
Published: 7 November 2008

Full text: You can view the full article, or view a printable version.
Comments: (login to access the comments on this article)

Author(s) : Scott-Jones J, Lawrenson R, Maxwell N.

Joseph Scott-JonesRoss LawrensonNina Maxwell

Citation: Scott-Jones J, Lawrenson R, Maxwell N.  Sharing after hours care in a rural New Zealand community – a service utilization survey. Rural and Remote Health (Internet) 2008; 8: 1024. Available: (Accessed 17 October 2017)


Click here to hear an introduction by the author

Introduction:  As the rural general practice workforce in New Zealand changes, after hours services are under pressure to change. This is an international problem. This article reports on an initiative in a rural New Zealand community to meet the need for after hours care. First contact for patients is with a community nursing team operating from the local health centre, complemented by on-call advice from GPs and GP clinics twice daily at weekends. Objective: To report on the demand for after hours services generated by a geographically defined community in New Zealand.
Methods:  Design: A prospective cross-sectional survey of after hours utilization over a one month period using questionnaires was completed by the full range of healthcare professionals providing care. Setting: A single geographically defined rural community of 9200 people in the North Island of New Zealand. Participants: Rural GPs, community nurses and the ambulance service.
Results:  Only 90/204 patient contacts were seen by the GPs with the remainder being managed by the nurses or ambulance staff. Nurses referred more patients to the base hospital but overall 87% of contacts handled by the doctors and nurses were managed locally. Estimated out of hours contact rate was 320/1000 persons/year (including telephone consultations). For direct face-to-face contact the rate was 245/1000 per year: for Maori the rate was 425/1000 per year while for non-Maori the rate was 151/1000 per year. Ambulance services provided an urgent call service at the rate of 29/1000 persons per year.
Conclusion:  A collaborative service providing after hours care to a rural community is described and utilization rates assessed. The model of first on-call nurse with GP back up provides a sustainable service and reduces the burden on rural doctors without reducing patient access.

Key words:  after hours care, general practice, New Zealand.

This abstract has been viewed 4543 times since 7-Nov-2008.