Children's unscheduled primary and emergency care in Ireland: a multimethod approach to understanding decision making, trends, outcomes and parental perspectives (CUPID): project protocol
Children's unscheduled primary and emergency care in Ireland: a multimethod approach to understanding decision making, trends, outcomes and parental perspectives (CUPID): project protocol
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DOI：
10.1136/bmjopen-2019-036729
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发表时间：
2020-01-01
期刊：
影响因子：
2.9
通讯作者：
Hensey, Conor
中科院分区：
文献类型：
--
作者：
McAuliffe, Eilish;Hamza, Moayed;Hensey, Conor
介绍本项目的目的是确定模式，决策过程和家长的喜好与计划外的儿科医疗保健利用在爱尔兰。计划外儿科保健是指由全科医生在初级保健环境中提供的门诊保健，儿科和综合医院的急诊科，以及在区域基础上运作的全科医生合作社提供的非工作时间服务。该项目将采取多方法的方法来分析利用计划外的儿科医疗保健的范围内的一个重大变化，在爱尔兰的幼儿医疗保健的提供-引入免费的全科医生在交付点照顾所有6岁以下的儿童。方法和分析将采用由三个工作包组成的多方法方法。工作包1将利用病人一级的数据描述初级保健、非工作时间医疗服务和急诊室的就诊模式。采用差异中的差异方法，将评估为6岁以下儿童提供免费全科医生护理对入学率的影响。工作包2将探讨急诊就诊的地理空间趋势，确定各地区和人口特征在艾德就诊方面的差异。工作包3将采用两个离散的选择实验，以检查父母的偏好不定期的儿科医疗保健和家庭医生的决策时，将一个孩子转介到ED。每个工作包单独和集体获得的见解将通知循证卫生政策的组织儿科护理和资源分配。伦理和传播本研究的伦理批准已获得都柏林大学学院、爱尔兰全科医师学院和五家参与医院的批准。研究结果将通过在同行评审期刊、国家和国际会议上发表，并向相关利益攸关方和利益集团传播。
Introduction The aim of this project is to determine the patterns, decision-making processes and parental preferences associated with unscheduled paediatric healthcare utilisation in Ireland. Unscheduled paediatric healthcare is outpatient care provided within primary care settings by general practitioners (GPs), emergency departments (EDs) located in paediatric and general hospitals, and out-of-hours services provided by cooperatives of GPs operating on a regional basis. This project will take a multimethod approach to analysing the utilisation of unscheduled paediatric healthcare nationally within the context of a significant change to the provision of healthcare for young children in Ireland-the introduction of free at the point of delivery GP care for all children aged under 6. Methods and analysis A multimethod approach consisting of three work packages will be employed. Using patient-level data, work package 1 will describe patterns of attendance at primary care, out-of-hours medical services and at EDs. Applying a difference-in-difference methodology, the impact of the introduction of free GP care for children under 6 on attendance will be assessed. Work package 2 will explore geospatial trends of attendance at EDs, identifying disparities in ED attendance by local area and demographic characteristics. Work package 3 will employ two discrete choice experiments to examine parental preferences for unscheduled paediatric healthcare and GP decision making when referring a child to the ED. The insights gained by each of the work packages individually and collectively will inform evidence-based health policy for the organisation of paediatric care and resource allocation. Ethics and dissemination Ethical approval for this research has been granted by University College Dublin, The Irish College of General Practitioners and the five participating hospitals. Results will be disseminated via publication in peer-reviewed journals, national and international conferences, and to relevant stakeholders and interest groups.