Investigating the impact of primary care payments on underdiagnosis in dementia: A difference-in-differences analysis

International Journal of Geriatric Psychiatry
Anne R MasonGerard McGonigal

Abstract

In England, two primary care incentive schemes were introduced to increase dementia diagnosis rates to two-thirds of expected levels. This study assesses the effectiveness of these schemes. We used a difference-in-differences framework to analyse the individual and collective impacts of the incentive schemes: (1) Directed Enhanced Service 18 (DES18: facilitating timely diagnosis of and support for dementia) and (2) the Dementia Identification Scheme (DIS). The dataset included 7529 English general practices, of which 7142 were active throughout the 10-year study period (April 2006 to March 2016). We controlled for a range of factors, including a contemporaneous hospital incentive scheme for dementia. Our dependent variable was the percentage of expected cases that was recorded on practice dementia registers (the "rate"). From March 2013 to March 2016, the mean rate rose from 51.8% to 68.6%. Both DES18 and DIS had positive and significant effects. In practices participating in the DES18 scheme, the rate increased by 1.44 percentage points more than the rate for non-participants; DIS had a larger effect, with an increase of 3.59 percentage points. These combined effects increased dementia registers nationally by an estimated 40 7...Continue Reading

References

Jul 25, 2009·The New England Journal of Medicine·Stephen M CampbellMartin Roland
Aug 12, 2009·Journal of Pain & Palliative Care Pharmacotherapy·UNKNOWN National Institute of Neurological Disorders, National Institutes of Health
Oct 23, 2013·Journal of Health Services Research & Policy·Søren Rud KristensenMatt Sutton
Oct 25, 2014·BMJ : British Medical Journal·Zosia Kmietowicz
Nov 8, 2014·BMJ : British Medical Journal·Zosia Kmietowicz
Dec 4, 2014·BMJ : British Medical Journal·Martin Brunet
Jun 17, 2015·BMJ : British Medical Journal·Louise RobinsonJohn-Paul Taylor
Nov 21, 2015·The American Journal of Emergency Medicine·Jessica Burns, Alfred Sacchetti
Jun 22, 2016·BMJ : British Medical Journal·Zosia Kmietowicz
Mar 31, 2017·The Economic Journal·Rita SantosCarol Propper

❮ Previous
Next ❯

Citations

Feb 26, 2019·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Dan LiuAnne Mason
May 22, 2019·BMC Family Practice·Stéphanie GiezendannerKlaus Bally
Nov 24, 2020·Clinical Interventions in Aging·Zyta Beata Wojszel

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.