New study examines how access to free GP care influences how frequently children use GP services

November 07, 2017

News
Growing Up in Ireland
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A new study published today (7 November) highlights the importance of access to GP care regardless of ability to pay. It also assesses the increased demand associated with free GP care, providing important evidence for policy on further extensions in free GP care.

The Growing Up in Ireland study found that children’s use of GP services increased when they became eligible for free GP care. Among children who did not have access to free GP care, the study found that children from higher income families were more likely to visit their GP.

The study was carried out on data collected before the extension of free GP care to children under 6 in 2015.

Main Findings

  • The study compared the type of GP access children had in 2008 (at the age of 9 months) and 2011 (at age 3). During this time, the proportion of children with full medical cards and GP visits cards increased. The proportion of children with private health insurance decreased.
  • Full medical card: In 2008, 26 per cent had full medical cards. In 2011, 34 per cent had full medical cards.
  • GP visit card: In 2008, 3 per cent had GP visit cards. In 2011, 4 per cent had GP visit cards.
  • Private health insurance with GP cover: In 2008, 29 per cent had private health insurance with cover for GP visits. In 2011, 26 per cent had this type of cover.
  • Private health insurance without GP cover: In 2008, 23 per cent had private health insurance without GP cover. In 2011, 20 per cent had this type of cover.
  • At both 9 months and 3 years of age, children with a full medical card or GP visit card had a significantly higher number of GP visits per annum than children who had no cover, i.e. no medical card, GP visit card or private health insurance. This was the case after adjusting for the child’s health needs, other child characteristics and family characteristics.
  • Among children without a full medical card or GP visit card, those in higher income families had more GP visits (particularly at the age of 9 months), even adjusting for their health. This suggests that lower income children without a full medical card or GP visit card faced financial barriers to accessing GP care.
  • The study tracked changes in the number of GP visits among children who gained a full medical card or GP visit card. The number of GP visits increased by 25 per cent per year among children who became eligible for free access to GP care.

 Policy Implications

  • While the study was carried out before the extension of free GP care to children under six in 2015, the study provides important evidence about how free GP care increases the demand for GP services. This evidence can be used by policymakers to assess the potential impact of extending free GP care to other groups.
  • At nine months, income played an important role when deciding to visit a GP for children without a full medical card or GP visit card. By age 3 years, this effect had largely disappeared. Wider eligibility for a full medical or GP visit card during the recession may have protected those who were previously above the threshold for a medical or GP visit card.

Anne Nolan, Associate Research Professor at the ESRI, commented: “Chronic ill-health can be a lifelong burden for the child, their family and the wider community. Early intervention is critical as health in early life is linked to outcomes in later life, including education and employment. For this reason, it is important to understand how the financing system for healthcare in Ireland can restrict children’s use of GP services.”

This report was published on the same day as the latest set of Key Findings, focusing on children aged 7/8 in Ireland. The press release for this report is available to read here.