Incentive schemes to increase dementia diagnoses in primary care in England: a retrospective cohort study of unintended consequences

The British Journal of General Practice : the Journal of the Royal College of General Practitioners
Dan LiuAnne R Mason

Abstract

The UK government introduced two financial incentive schemes for primary care to tackle underdiagnosis in dementia: the 3-year Directed Enhanced Service 18 (DES18) and the 6-month Dementia Identification Scheme (DIS). The schemes appear to have been effective in boosting dementia diagnosis rates, but their unintended effects are unknown. To identify and quantify unintended consequences associated with the DES18 and DIS schemes. A retrospective cohort quantitative study of 7079 English primary care practices. Potential unintended effects of financial incentive schemes, both positive and negative, were identified from a literature review. A practice-level dataset covering the period 2006/2007 to 2015/2016 was constructed. Difference-in-differences analysis was employed to test the effects of the incentive schemes on quality measures from the Quality and Outcomes Framework (QOF); and four measures of patient experience from the GP Patient Survey (GPPS): patient-centred care, access to care, continuity of care, and the doctor-patient relationship. The researchers controlled for effects of the contemporaneous hospital incentive scheme for dementia and for practice characteristics. National practice participation rates in DES18 and D...Continue Reading

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Citations

Dec 17, 2020·BMC Medicine·KongFatt Wong-LinBernadette McGuinness
Dec 25, 2021·Journal of Geriatric Psychiatry and Neurology·Michelle ParkerLeanne M Aitken
Jan 4, 2022·Alzheimer's & Dementia : the Journal of the Alzheimer's Association·Siang Ing LeeKrishnarajah Nirantharakumar

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