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

Marta Buszewicz, Catherine Welch, Laura Horsfall, Irwin Nazareth, David Osborn, Angela Hassiotis, Gyles Glover, Umesh Chauhan, Matthew Hoghton, Sally-Ann Cooper, Gwen Moulster, Rosalyn Hithersay, Rachael Hunter, Pauline Heslop, Ken Courtenay, André Strydom

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

BACKGROUND: 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.

METHODS: 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.

FINDINGS: 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).

INTERPRETATION: Targeted annual health checks for people with ID in primary care could reduce health inequities.

FUNDING: National Institute for Health Research.

Original languageEnglish
Pages (from-to)522-530
Number of pages9
JournalLancet Psychiatry
Volume1
Issue number7
DOIs
Publication statusPublished - Dec 2014

Structured keywords

  • IAS

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