Free children's visits increase care and workforce burden

In July 2015, all children under six years of age gained free access to daytime and out-of-hours general practice services in the Republic of Ireland, resulting in a 25 percent increase in utilization.

Comparing the year prior to the introduction of free GP care with the following year, daytime general practitioner visits by children under six years increased from 9,789 to 12,600, while out-of-hours visits increased from 15,087 to 18,958.

In the post-period, nine percent more children were seen at least once in daytime services and 20 percent more children were seen at least once out-of-hours.

While visits by patients of all ages increased in the post-period, children under age six were responsible for a disproportionate increase in service utilization, accounting for 45 percent of additional daytime visits and 73 percent of additional out-of-hours visits.

Given the inevitable increase in service utilization that accompanies the availability of free care, and with indications that Ireland's GP workforce may soon struggle to meet demand, the authors call for careful workforce planning if state-funded general practice care is extended to other groups.