The effect of differential eligibility for free GP services on GP utilisation in Ireland

Nolan, Alexis; Smith, Samantha

doi:10.1016/j.socscimed.2012.02.007

Cited by 41 publications

(19 citation statements)

References 25 publications

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“…Indeed, they reported seeking their GP’s endorsement of information obtained from other sources. Nolan & Smith [21] found that GP utilisation was significantly more likely where the service was free. Thus, different systems of healthcare provision may themselves influence the process of lifestyle change.…”

Section: Discussionmentioning

confidence: 99%

Do practitioners and friends support patients with coronary heart disease in lifestyle change? a qualitative study

Cole¹,

Smith

Hart³

et al. 2013

BMC Fam Pract

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BackgroundHealthy lifestyles help to prevent coronary heart disease (CHD) but outcomes from secondary prevention interventions which support lifestyle change have been disappointing. This study is a novel, in-depth exploration of patient factors affecting lifestyle behaviour change within an intervention designed to improve secondary prevention for patients with CHD in primary care using personalised tailored support. We aimed to explore patients’ perceptions of factors affecting lifestyle change within a trial of this intervention (the SPHERE Study), using semi-structured, one-to-one interviews, with patients in general practice.MethodsInterviews (45) were conducted in purposively selected general practices (15) which had participated in the SPHERE Study. Individuals, with CHD, were selected to include those who succeeded in improving physical activity levels and dietary fibre intake and those who did not. We explored motivations, barriers to lifestyle change and information utilised by patients. Data collection and analysis, using a thematic framework and the constant comparative method, were iterative, continuing until data saturation was achieved.ResultsWe identified novel barriers to lifestyle change: such disincentives included strong negative influences of social networks, linked to cultural norms which encouraged consumption of ‘delicious’ but unhealthy food and discouraged engagement in physical activity. Findings illustrated how personalised support within an ongoing trusted patient-professional relationship was valued. Previously known barriers and facilitators relating to support, beliefs and information were confirmed.ConclusionsIntervention development in supporting lifestyle change in secondary prevention needs to more effectively address patients’ difficulties in overcoming negative social influences and maintaining interest in living healthily.

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Section: Discussionmentioning

confidence: 99%

Do practitioners and friends support patients with coronary heart disease in lifestyle change? a qualitative study

Cole¹,

Smith

Hart³

et al. 2013

BMC Fam Pract

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“…This has resulted in increased health disparities with no change in patient demand. [25][26][27][28] Governments in these countries end up reimbursing, capping, and waiving the copayment to reduce health disparities. 24 The overall costs of these remedial actions are not usually available.…”

Section: Head To Head Copayments Don't Workmentioning

confidence: 99%

Should patients pay to see the GP?

Jones¹,

Loader²

2016

BMJ

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“…Differences in entitlement to care (including sub-groups differentiated by income level) and utilization of care between the two parts of Ireland have been explored previously for the overall population (33,37,38). As far at the authors are aware a needs adjusted comparison of health care utilisation by people with diabetes is not available.…”

Section: Introductionmentioning

confidence: 99%

A comparison, for older people with diabetes, of health and health care utilisation in two different health systems on the island of Ireland

Pierse

Barry

Glynn

et al. 2020

Preprint

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Background: There are social and economic differences between Northern Ireland (NI) and the Republic of Ireland (ROI). There are also differences in the health care systems in the two jurisdictions. The aims of this study are to compare health (prevalence of diabetes and related complications) and health care utilisation (general practitioner, outpatient or accident and emergency utilisation) among older people with diabetes in the NI and ROI. Methods: Large scale comparable surveys of people over 50 years of age in Northern Ireland (NICOLA, wave 1) and the Republic of Ireland (TILDA, wave 1) are used to compare people with diabetes (type I and type II) in the two jurisdictions. The combined data set comprises 1,536 people with diabetes. A coarsened exact matching approach is used to compare health care utilisation among people with diabetes in NI and ROI with equivalent demographic, lifestyle and illness characteristics (age, gender, education, smoking status and self-related health, number of other chronic diseases and number of diabetic complications).Results: The overall prevalence of diabetes in the 50 to 84 years old age group is 3.4 percentage points higher in NI (11.1% in NI, 7.7% ROI, p-value < 0.01). The diabetic population in NI appear sicker – with more diabetic complications and more chronic illnesses. Comparing people with diabetes in the two jurisdictions with similar levels of illness we find that there are no statistically significant differences in GP, outpatient or A&E utilisation.Conclusion: Despite the proximity of NI and ROI there are substantial differences in the prevalence of diabetes and its related complications. Despite differences in the health services in the two jurisdictions the differences in health care utilisation for an equivalent cohort are small.

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The effect of differential eligibility for free GP services on GP utilisation in Ireland

Cited by 41 publications

References 25 publications

Do practitioners and friends support patients with coronary heart disease in lifestyle change? a qualitative study

Do practitioners and friends support patients with coronary heart disease in lifestyle change? a qualitative study

Should patients pay to see the GP?

A comparison, for older people with diabetes, of health and health care utilisation in two different health systems on the island of Ireland

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