Would universal general practitioner care impact Irish adolescents' utilisation?

Health Policy. 2022 Jul;126(7):652-660. doi: 10.1016/j.healthpol.2022.04.005. Epub 2022 Apr 14.

Abstract

Introduction: Health systems' characteristics influence individuals' health care utilisation. Unlike their European neighbours the majority of Irish citizens pay for General Practitioner (GP) care. The current strategy for health care reform proposes universal GP care (i.e. the removal of GP care fees), to be introduced on a phased basis, prioritising under 18s.

Methods: Employing data from the Growing Up in Ireland survey, and controlling for health care need, and other predisposing and enabling factors, propensity score matching is used to estimate the effect of GP cover (free GP care at point of use) on GP utilisation over a 12-month period amongst 16/17 year olds (n= 4308).

Results: Results indicate having GP cover increases the average number of GP consultations by 38% per annum. When the sample is restricted to individuals without chronic conditions, a 42% increase in annual number of GP consultations is found. It is reasonable to expect that extending free GP care via a universal care model would be associated with a higher propensity to utilise GP services amongst 16/17 year olds.

Conclusions: This has economic implications for health care budgets and workforce planning. While most adolescents are healthy, investment in their health provides current and future health benefits; however a universal system will require investment, necessitating displacement of resources elsewhere, to meet demand.

Keywords: Adolescents; General practitioner; Growing up in Ireland (GUI); Propensity score matching; Universal; Utilisationp.

MeSH terms

  • Adolescent
  • Fees and Charges
  • General Practitioners*
  • Health Services Accessibility
  • Humans
  • Patient Acceptance of Health Care
  • Referral and Consultation