Healthcare use among preschool children attending GP-led urgent care centres: a descriptive, observational study
S Gnani1, S Morton1, F Ramzan1
1Department of Primary Care and Public Health, Imperial College London, London, UK.
Insights
General practitioner-led urgent care centres (UCCs) see many young children for respiratory issues, often outside of regular hours. Most children are discharged home, but further study is needed on their impact on emergency department use.
Area of Science:
- Pediatric Emergency Medicine
- Urgent Care Services
- General Practice
Background:
- Urgent care centres (UCCs) in England aim to reduce inappropriate emergency department (ED) attendances.
- GP-led UCCs with extended hours were studied to understand their role in pediatric care.
- Understanding UCC utilization patterns is crucial for healthcare resource allocation.
Purpose of the Study:
- To examine the presenting complaints and care outcomes for children under 5 years old attending GP-led UCCs.
- To compare attendance rates at GP-led UCCs versus general practices for preschool children.
- To assess the management and disposition of pediatric patients in UCC settings.
Main Methods:
- Retrospective observational epidemiological study utilizing routinely collected data.
- Analysis of attendances of children under 5 years at two London-based GP-led UCCs over a 3-year period.
- Comparison of UCC visit rates with general practice data for preschool children.
Main Results:
- Children under 5 constituted 3% of UCC attenders, with respiratory illnesses being the most common reason for visit (27%).
- The majority of children (91%) were registered with a GP, and over two-thirds of visits occurred outside standard hours.
- Most children (79%) were seen and discharged home, with GP-led UCCs managing cases comparable to ED presentations.
Conclusions:
- Two-thirds of preschool children attend GP-led UCCs outside of regular hours, even when registered with a GP.
- The majority of pediatric cases in GP-led UCCs are managed and discharged by general practitioners.
- Further research is needed to determine the impact of GP-led urgent care systems on emergency care utilization.
Objective:
Urgent care centres' (UCCs) hours were developed with the aim of reducing inappropriate emergency department (ED) attendances in England. We aimed to examine the presenting complaint and outcomes of care in 2 general practitioner (GP)-led UCCs with extended opening times.
Design:
Retrospective observational epidemiological study using routinely collected data.
Setting:
2 GP-led UCCs in London, colocated with a hospital ED.
Participants:
All children aged under 5 years, attending 2 GP-led UCCs over a 3-year period.
Outcomes:
Outcomes of care for the children including: primary diagnosis; registration status with a GP; destination following review within the UCC; and any medication prescribed. Comparison between GP-led UCC visit rates and routine general practices was also made.
Results:
3% (n=7747/282 947) of all attenders at the GP-led UCCs were children aged under 5 years. The most common reason for attendance was a respiratory illness (27%), followed by infectious illness (17%). 18% (n=1428) were either upper respiratory tract infections or viral infections. The majority (91%) of children attending were registered with a GP, and over two-thirds of attendances were 'out of hours'. Overall 79% were seen and discharged home. Preschool children were more likely to attend their GP (47.0 per 100) than a GP-led UCC (9.4 per 100; 95% CI 8.9 to 10.0).
Conclusions:
Two-thirds of preschool children attending GP-led UCCs do so out of hours, despite the majority being registered with a GP. The case mix is comparable with those presenting to an ED setting, with the majority managed exclusively by the GPs in the UCC before discharge home. Further work is required to understand the benefits of a GP-led urgent system in influencing future use of services especially emergency care.
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