How does the introduction of free GP care for children impact on GP service provision? A qualitative study of GPs.
Child health
GP service utilisation
Healthcare policy
Paediatrics
Primary health care
Journal
Irish journal of medical science
ISSN: 1863-4362
Titre abrégé: Ir J Med Sci
Pays: Ireland
ID NLM: 7806864
Informations de publication
Date de publication:
Nov 2019
Nov 2019
Historique:
received:
17
12
2018
accepted:
27
02
2019
pubmed:
11
3
2019
medline:
14
1
2020
entrez:
11
3
2019
Statut:
ppublish
Résumé
Optimising child health in general practice is a key health service priority. In Ireland, where 23% of Ireland's population are aged under 16, GP consultations have historically involved a private fee or have been covered by Ireland's General Medical Services (GMS) scheme. In July 2015, this scheme was expanded so that free GP care was provided to all children aged under 6 years. Recent research suggests this change in policy has led to a substantial increase in the number of children under six attending both daytime and out-of-hour GP services and highlights a need to better understand the perspectives of GPs on this policy change. To address these knowledge gaps, this paper aims to examine GPs' views on the scheme and how it has impacted on their practice. Sixteen GPs participated in semi-structured telephone interviews between June and August 2016, analysed using inductive thematic analysis. Six key themes were identified: (1) increased service utilisation, (2) changes in parental behaviour when accessing services, (3) increased 'out of hours' service utilisation, (4) dissatisfaction with the current resourcing of the scheme, (5) limited capacity to support expansion of free GP care, and (6) reduced antibiotic prescribing. The study highlights how introducing free GP care to a mixed private/publicly funded health system may impact on GP workload, parents' interaction with services and physician practice.
Sections du résumé
BACKGROUND
BACKGROUND
Optimising child health in general practice is a key health service priority. In Ireland, where 23% of Ireland's population are aged under 16, GP consultations have historically involved a private fee or have been covered by Ireland's General Medical Services (GMS) scheme. In July 2015, this scheme was expanded so that free GP care was provided to all children aged under 6 years. Recent research suggests this change in policy has led to a substantial increase in the number of children under six attending both daytime and out-of-hour GP services and highlights a need to better understand the perspectives of GPs on this policy change.
AIM
OBJECTIVE
To address these knowledge gaps, this paper aims to examine GPs' views on the scheme and how it has impacted on their practice.
METHODS
METHODS
Sixteen GPs participated in semi-structured telephone interviews between June and August 2016, analysed using inductive thematic analysis.
RESULTS
RESULTS
Six key themes were identified: (1) increased service utilisation, (2) changes in parental behaviour when accessing services, (3) increased 'out of hours' service utilisation, (4) dissatisfaction with the current resourcing of the scheme, (5) limited capacity to support expansion of free GP care, and (6) reduced antibiotic prescribing.
CONCLUSIONS
CONCLUSIONS
The study highlights how introducing free GP care to a mixed private/publicly funded health system may impact on GP workload, parents' interaction with services and physician practice.
Identifiants
pubmed: 30852807
doi: 10.1007/s11845-019-01997-7
pii: 10.1007/s11845-019-01997-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1245-1249Références
Health Serv Res. 2000 Feb;34(6):1273-302
pubmed: 10654830
Ann Fam Med. 2018 May;16(3):246-249
pubmed: 29760029
Ir Med J. 2014 Apr;107(4):121-2
pubmed: 24834590
Ir Med J. 2007 Sep;100(8):suppl 3-6
pubmed: 17955692
BMJ. 2016 Feb 23;352:i1076
pubmed: 26907802
Adm Policy Ment Health. 2015 Sep;42(5):533-44
pubmed: 24193818
Adm Policy Ment Health. 2011 Mar;38(2):65-76
pubmed: 20957426