Healthcare use among preschool children attending GP-led urgent care centres: a descriptive, observational study.

Healthcare use among preschool children attending GP-led urgent care centres: a descriptive, observational study.

BMJ Open. 2016;6(6):e010672

Authors: Gnani S, Morton S, Ramzan F, Davison M, Ladbrooke T, Majeed A, Saxena S

Abstract
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.

PMID: 27288373 [PubMed - as supplied by publisher]

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