The accessibility of primary care and paediatric hospitalisations for ambulatory care sensitive conditions in Czechia

This study evaluates the accessibility of primary care for children in Czechia in light of the declining numbers of general practitioners and the rising numbers of children without a practitioner. We show that children largely receive primary care outside their district of administrative residence, that the average number of children registered per practitioner is increasing, and that the share of children without a practitioner was over 6% in 2022. This study further challenges the use of hospital admissions for ambulatory care sensitive conditions as a measure of the accessibility and quality of primary care. We build a fixed-effects model for district-level data on paediatric hospital admissions and the utilisation of primary care between 2010 and 2019 in Czechia. Our focus is on the effect that the number of registered and treated children per primary-care physician has on the composition of paediatric hospital admissions. We find no significant relationship between the variables of our interest. Therefore, we suggest that hospital admissions for ambulatory care sensitive conditions are not a good measure of the accessibility and quality of primary care for the child population in Czechia, a country with compulsory health insurance and no gatekeeping of primary care.