Abstract
BackgroundGeneral practice (GP) has historically been central to the prevention and treatment of childhood illnesses. In Ireland, this role has recently expanded with the introduction of free GP care for children aged under six years in 2015. The Republic of Ireland has the only health system in the European Union which does not offer universal coverage for primary care. This study aims to analyse general practice records to investigate the effect of point of care consultation fees on childhood attendances.MethodsGPs affiliated to the medical school (n = 72) were invited to participate. 100 children aged 1 to 14 years were randomly sampled from each. Data was collected on service utilisation in the previous 12 months, specifically: age, gender, eligibility for free care and whether they had consulted their GP in the 12 month period.ResultsSixty-four practices participated, producing data on 6007 eligible children. The median age of children was seven years; 3688(62%) were ‘fee-paying’. GMS patients aged under six years had a median of three consultations/year, with a quarter attending six times a year or more, while fee paying patients had a median of two consultations/year with a quarter attending four times a year or more.ConclusionsChildren eligible for free care attend more often with a subgroup attending very frequently. This study provides important information on the possible impact of fees on healthcare utilisation for countries considering co-payment.
Highlights
General practice (GP) has historically been central to the prevention and treatment of childhood illnesses
The majority of childhood illness in the western world is managed by general practitioners (GPs) [1], with most children in the UK attending their GP three to six times per year [2]
3105 (52%) of children in the sample had a consultation with their general practitioner within the last year (71% of those eligible for fee exemption consultations vs. 40% of fee-paying, p < 0.001, Cramer’s V = 0.30)
Summary
General practice (GP) has historically been central to the prevention and treatment of childhood illnesses. In Ireland, this role has recently expanded with the introduction of free GP care for children aged under six years in 2015. This study aims to analyse general practice records to investigate the effect of point of care consultation fees on childhood attendances. The majority of childhood illness in the western world is managed by general practitioners (GPs) [1], with most children in the UK attending their GP three to six times per year [2]. Acute cough alone in the 0–4 age group is estimated to cost the National Health Service in the UK £31.5 million per year, mainly through consultations in general practice [3]. Fee-for-service predominate in Belgium, Denmark and France and involves payment calculated on work performed.
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