Assessment of an incentivised scheme to provide annual health checks in primary care for adults with intellectual disability: a longitudinal cohort study

Buszewicz, M. et al. (2014) Assessment of an incentivised scheme to provide annual health checks in primary care for adults with intellectual disability: a longitudinal cohort study. Lancet Psychiatry, 1(7), pp. 522-530. (doi:10.1016/S2215-0366(14)00079-0)

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Publisher's URL: http://dx.doi.org/10.1016/S2215-0366(14)00079-0

Abstract

Background<p></p> People with intellectual disabilities (ID) have many comorbidities but experience inequities in access to health care. National Health Service England uses an opt-in incentive scheme to encourage annual health checks of patients with ID in primary care. We investigated whether the first 3 years of the programme had improved health care of people with ID.<p></p> Methods<p></p> We did a longitudinal cohort study that used data from The Health Improvement Network primary care database. We did multivariate logistic regression to assess associations between various characteristics and whether or not practices had opted in to the incentivised scheme.<p></p> Findings<p></p> We assessed data for 8692 patients from 222 incentivised practices and those for 918 patients in 48 non-incentivised practices. More blood tests (eg, total cholesterol, odds ratio [OR] 1•88, 95% CI 1•47–2•41, p<0•0001) general health measurements (eg, smoking status, 6•0, 4•10–8•79, p<0•0001), specific health assessments (eg, hearing, 24•0, 11•5–49•9, p<0•0001), and medication reviews (2•23, 1•68–2•97, p<0•0001) were done in incentivised than in non-incentivised practices, and more health action plans (6•15, 1•41–26•9, p=0•0156) and secondary care referrals (1•47, 1•05–2•05, p=0•0256) were made. Identification rates were higher in incentivised practices for thyroid disorder (OR 2•72, 95% CI 1•09–6•81, p=0•0323), gastrointestinal disorders (1•94, 1•03–3•65, p=0•0390), and obesity (2•49, 1•76–3•53, p<0•0001).<p></p> Interpretation<p></p> Targeted annual health checks for people with ID in primary care could reduce health inequities.<p></p>

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cooper, Professor Sally-Ann
Authors: Buszewicz, M., Welch, C., Horsfall, L., Nazareth, I., Osborn, D., Hassiotis, A., Glover, G., Chauhan, U., Hoghton, M., Cooper, S.-A., Moulster, G., Hithersay, R., Hunter, R., Heslop, P., Courtenay, K., and Strydom, A.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
Journal Name:Lancet Psychiatry
Publisher:The Lancet Publishing Group
ISSN:2215-0374
ISSN (Online):2215-0366
Copyright Holders:Copyright © 2014 The Authors
First Published:First published in Lancet Psychiatry 1(7):522-530
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
626931Health checks for people with Learning Disabilities: improving their uptake and effectivenessSally-Ann CooperNational Institute for Health Research (NIHR)RP-DG-0611-1000IHW - MENTAL HEALTH & WELLBEING