Big jump in GP visits by under-6s

Increase due to free GP care - study
  • Deborah Condon

Children under the age of six are attending GPs much more often since free GP care was introduced for this age group in 2015, a new study has found.

In July 2015, all children under the age of six were granted free access to daytime and out-of-hours GP services, regardless of parental income. This amounted to some 440,000 children.

Prior to this, around 70% of children under six did not have free GP access.

Researchers at Trinity College Dublin (TCD) decided to look into the impact of this decision on GP visits.

They found that the introduction of free GP care has led to a 29% increase in visits to daytime services by young children, along with a 26% increase in out-of-hours visits.

The findings are based on data from eight GP practices in north Dublin and the local out-of-hours service (NorthDoc). Over 300,000 face-to-face consultations took place in the year leading up to the introduction of free access, and the year after.

The researchers found that during this period, the use of both daytime and out-of-hours services increased across all age categories. However, children under six were responsible for a disproportionate amount of the increased workload.

Altogether, children under the age of six made up 45% of additional visits to daytime GP services in the year after the introduction of free access, and 73% of additional visits to out-of-hours services.

According to the study's lead author, GP and TCD researcher, Dr Michael O'Callaghan, ‘it is no surprise that GP services are used more often when free'.

"This study shows conclusively that large numbers of additional children availed of GP services and availed of these services more often once they gained free access. Our study also demonstrates the ‘knock-on' effect of the under-6s contract in the out-of-hours service, which experienced a disproportionately large spike in numbers of children under six attending," he commented.

He pointed out that the study shows that GP services in Ireland ‘are getting busier in general'.

"GPs saw more patients of all ages in the second year of the study. However, almost half of additional visits to the daytime services, and three-quarter of the additional visits to the out-of-hours service, were generated by the under-6s.

"As we have no reason to believe that the cohort experienced more ill health in the second year of the study, we can conclude that the large increases were simply as a result of the introduction of free GP care," Dr O'Callaghan said.

He warned that GP services are already under severe pressure and any further expansion of free care ‘will lead to increased utilisation, which will have significant implications for daytime and out-of-hours services'.

"Such increased utilisation could de-stabilise Irish general practice as it exists at present. There will be knock-on effects for Emergency Departments and hospitals," Dr O'Callaghan added.

The researchers insisted that any future plans to extend free GP care require careful workforce planning.

"This study shows that workload planning is required when any changes to GP access are made. If not, access to frontline GP services will be undermined for everyone," commented study author, Prof Tom O'Dowd, of TCD.

Details of these findings are published in the journal, Annals of Family Medicine.


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