Department of Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
Department of Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland.
Ann Fam Med. 2018 May;16(3):246-249. doi: 10.1370/afm.2229.
In July 2015, all children aged younger than 6 years gained free access to daytime and out-of-hours general practice services in the Republic of Ireland. Although 30% previously had free access, 70% did not.
To examine subsequent changes in service use, we retrospectively analyzed anonymized visitation data from 8 general practices in North Dublin providing daytime service and their local out-of-hours service, comparing the 1 year before and the 1 year after introduction of free care.
In the year after granting of free general practice care for children younger than 6 years, 9.4% more children attended the daytime services and 20.1% more children were seen in the out-of-hours services. Annual number of visits by patients increased by 28.7% for daytime services and by 25.7% for out-of-hours services, translating to 6,682 more visits overall. Average visitation rate for children this age increased from 2.77 visits per year to 3.25 visits per year for daytime services, but changed little for out-of-hours services, from 1.52 visits per year to 1.59 visits per year.
Offering free childhood general practice services led to a dramatic increase in visits. This increase has implications for future health care service planning in mixed public and privately funded systems.
2015 年 7 月，爱尔兰共和国所有 6 岁以下儿童均可免费获得日间和非工作时间的全科医疗服务。尽管此前有 30%的儿童可以免费获得服务，但仍有 70%的儿童无法获得。
为了研究服务使用情况的后续变化，我们回顾性分析了都柏林北部 8 家提供日间服务的全科诊所及其当地非工作时间服务的匿名就诊数据，比较了免费护理实施前一年和后一年的数据。
在向 6 岁以下儿童免费提供全科医疗服务的一年后，有 9.4%的儿童更多地使用日间服务，有 20.1%的儿童更多地使用非工作时间服务。日间服务的年就诊次数增加了 28.7%，非工作时间服务的年就诊次数增加了 25.7%，总就诊次数增加了 6682 次。该年龄段儿童的平均就诊率从日间服务的每年 2.77 次增加到每年 3.25 次，但非工作时间服务的就诊率变化不大，从每年 1.52 次增加到每年 1.59 次。
提供免费的儿童全科医疗服务导致就诊次数大幅增加。这一增长对混合公共和私人资助系统的未来医疗保健服务规划具有重要意义。
