The Gospel Oak project 1987-1990: provision and use of community services.
This longitudinal survey of elderly people examines morbidity and service usage. 705 elderly people who lived in their own homes were interviewed as part of the Gospel Oak project in 1987/88, and in 1990, 524 (74.3%) were re-interviewed--90 (12.8%) had died, 51 (7.2%) had moved and 40 (5.7%) refused a follow-up interview. The results indicate that 60% of residents (1987/88 and 1990) had been in contact with community services within the month before the survey. Respondents with depression were mostly in contact with the health service, those with dementia were in contact with social services. Long-term activity-limited people had high contact with both services, although this finding was less likely among newly activity-limited people. Multiple service-users from the first survey were likely to be either dead, or high service-users in 1990. Low service-users tended to continue to be low service-users. New users were generally living alone, aged around 70 years and had been relatively healthy previously. Respondents who stopped using services were generally younger, mostly women, and possibly depressed. People who had never been service-users, were generally younger and healthier. Information on community services performance is inadequate to ensure targeted, efficient services, and this survey gives detailed information to help planning and resource allocation.