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

Buszewicz, MJ; Welch, C; Horsfall, L; Nazareth, I; Osborn, D; Hassiotis, A; Glover, G; ... Strydom, A; + view all (2014) Assessment of an incentivised scheme to provide annual health checks in primary care for adults with intellectual disability: a longitudinal cohort study. The Lancet Pyschiatry , 1 (7) pp. 522-530. 10.1016/S2215-0366(14)00079-0. Green open access

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Abstract

Background People with Intellectual Disabilities (ID) have significant health co-morbidities but experience health inequities across the world resulting in excess avoidable deaths. In England, the National Health Service introduced an incentivised scheme encouraging GPs to offer annual health checks to adults with ID to address these inequities. This study evaluates the first three years of the programme. Methods Longitudinal cohort study (8,790 adults with ID) using The Health Improvement Network (THIN) primary care database. Findings Practices that adopted the incentivised health check scheme for adults with ID performed more blood tests (e.g. total cholesterol: OR =1.88; 1.47 to 2.41, p < .001) general health measurements (e.g. smoking status: OR = 6.0; 4.1 – 8.79, p < .001), specific health assessments (e.g. hearing: OR = 24.0; 11.5 to 49.9, p < .001), medication reviews (OR = 2.23; 1.68, 2.97, p < .001), health action plans (OR = 6.15; 1.41, 26.9, p = .016) and made more secondary care referrals (OR = 1.47; 1.05, 2.05, p = .026) for ID patients than non-adopting practices. Identification rates for thyroid disorder (OR = 2.72; 1.09, 6.81, p = .032), gastrointestinal disorders (OR = 1.94; 1.03, 3.65, p = .039) and obesity (OR = 2.49; 1.76, 3.53), p < .001) were also higher. However, 40% (811/2034) of patients with specific ID syndromes (e.g. Down syndrome) did not have a diagnosis of ID recorded and were not invited for a health check. Interpretation Targeting people with ID for annual health checks in primary care could be effective in reducing health inequities, increase identification of co-morbidities, and potentially reduce avoidable deaths, but many ID patients do not benefit due to exclusion from ID registers or non-attendance. Funding Independent research funded by the National Institute for Health Research Programme Development Grants Programme (Reference Number RP-DG-0611-10003).

Type: Article
Title: Assessment of an incentivised scheme to provide annual health checks in primary care for adults with intellectual disability: a longitudinal cohort study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/S2215-0366(14)00079-0
Publisher version: http://dx.doi.org/10.1016/S2215-0366(14)00079-0
Language: English
Additional information: © Buszewicz et al. Open Access article distributed under the term of CC BY.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/1448842
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