The association of geographical location and neighbourhood deprivation with older people's use of NHS direct: A population-based study

Background: no research has investigated how older people's use of NHS Direct, the 24-h telephone health advice and information service in England and Wales, varies according to geographical location and deprivation.Objectives: to describe the geographic pattern of older people's use of NHS Direct and examine the relationship between service use and deprivation.Design: descriptive, exploratory, cross-sectional, population-based study.Setting: calls to all 32-NHS Direct contact centres in England/Wales.Participants: people aged 65 years and above who used NHS Direct between 1 December 2007 and 30 November 2008.Results: differences in older people's use of NHS Direct were observed in England and Wales. In England, the call rate was highest in Yorkshire and the Humber and was lowest in the West Midlands. At the postcode level, the rate of calls ranged from 0.167 (Blackburn) to 0.011 (Carlisle) per person per annum. In England, but not in Wales, the level of deprivation was associated with the rate of calls, older people living in the most deprived areas had the highest rate of calls to NHS Direct.Conclusions: the results are useful for future planning to meet the needs of older people, and in informing national policies for the development of NHS Direct.