BACKGROUND Effectivization of the Norwegian out-of-hours primary care medical services has probably rendered the services less available to residents in nursing homes in many places. In Bergen, an out-of-hours medical service especially dedicated to residents in retirement and nursing homes and people with special needs living at home, was established in March 2006. We wanted to assess this medical service after its first year of activity. METHODS Data were prospectively recorded on when the services were used and characteristics of the users . Information about the institutions was also recorded. RESULTS 926 patients used the services during the first year; more than half of them received sick calls. Pneumonias and urinary tract infections were the most common diagnoses. A high level of doctor staffing at the nursing homes did not lead to decreased use. Neither the total number of beds nor the number of short - time beds in the nursing homes had a significant influence on the use of this service. CONCLUSIONS This targeted out-of-hours service was used less than expected during its first year. The nursing homes' use of this service is determined by factors other than the number of beds and doctor staffing.