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Children’s unscheduled primary and emergency care in Ireland: decision making, trends, outcomes and parental perspectives (CUPID)

Background
In 2011 the programme for government outlined an intent to transition Ireland from a part-public and part-privately funded health system to one of universal healthcare. In July 2015 GP visit cards enabling free access to primary care were afforded to under 6 year olds and over 70 year olds. International experiences have highlighted that high quality accessible primary care confers beneficial child health outcomes. However, free care does not equate accessible care. Concerns regarding increasing Emergency Department attendance, paucity of research regarding changes to healthcare organisation in Ireland and their impact on child health necessitate further enquiry.
Aim
To elucidate the patterns, outcomes and decision-making processes associated with paediatric healthcare utilisation in Ireland and the impact of free GP care for the under 6 years old cohort. We propose to address this aim by pairing methodological rigour with a patient-centred approach that accounts for the perspectives of parents and frontline staff.
Research Design
A multi-method approach will be employed and includes joinpoint analysis of temporal trends of attendance and outcomes, geospatial and demographic exploration, systematic review, qualitative enquiry and discrete choice modelling of parental and GP decision making. Each work package will further insights gained in other streams of the project to form a context rich picture of a complex issue by answering related questions regarding paediatric attendance and outcomes in Ireland.
Impact
The beneficiaries of this project are children, parents, healthcare professionals and policy makers. Understanding if, where and why inequities in outcomes and access to services exist will allow appropriate action to be taken. The potential impact is development of evidence-based health policy, targeted intervention and appropriate resource allocation. Exploring the impact of free primary care for the under 6 population will identify areas of primary and emergency care that require consolidation prior to further policy changes.