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 > School of Health & 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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