A Retrospective Analysis of ED Attendance Trends by Under 6-Year-Olds and Under 8-Year-Olds Following the Implementation of Free GP Care for Those Age-Groups in Ireland

Introduction: The Irish government has sought to improve access to primary care by introducing free GP cards for under-6-year olds in 2015 and under-8-year-olds in 2023. This retrospective review analyzed the impact on Emergency Department (ED) attendance in Wexford General Hospital (WGH). Methods: ED attendance data from before and after the implementation of the new policy was collated from the automated system-generated attendance reports. For under 6-year-olds, data from July 2014 to June 2015 was compared to July 2015 to June 2016. For the under 8-year-olds, data from August 2022 - July 2023 and mean annual data from August 2014 till July 2023 were compared to August 2023 - July 2024. Interpretation of the results was correlated with the national census data from 2011, 2016, and 2022. Results: Despite an anticipated decrease in ED attendances in this age group due to apparent improved access to primary care, there was a 33.2% increase in under 8-year-olds presenting when comparing 2022/2023 to 2023/2024 (n = 5702 to n = 7595), and a 0.72% increase in under 6-year-olds in 2014/2015 to 2015/2016 (n = 4148 to n = 4178). Mean analysis from 2014/2015 to 2022/2023 revealed an increase of 38.34% (n = 5490 to n = 7595) for the under-6 population. This is not accounted for by a growth in this population group, according to census data from 2011 to 2022. Conclusion: Despite the initiative to improve access to primary care for children, an increase in the number of ED attendances in this patient group was noted. It is unclear what this apparent paradox can be attributed to, but it would be beneficial to further compare how many of these ED attendances were referred by GP’s before and after the introduction of the new policies, and to correlate this with the number of GP’s practicing in the WGH catchment area over this period.