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Impact of Financial Incentives on Alcohol Consumption Recording in Primary Health Care Among Adults with Schizophrenia and Other Psychoses: A Cross-Sectional and Retrospective Cohort Study.

Khadjesari, Z; Hardoon, SL; Petersen, I; Hamilton, FL; Nazareth, I; (2017) Impact of Financial Incentives on Alcohol Consumption Recording in Primary Health Care Among Adults with Schizophrenia and Other Psychoses: A Cross-Sectional and Retrospective Cohort Study. Alcohol and Alcoholism , 52 (2) pp. 197-205. 10.1093/alcalc/agw076. Green open access

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Abstract

AIMS: Lack of financial incentive is a frequently cited barrier to alcohol screening in primary care. The Quality and Outcomes Framework (QOF) pay for performance scheme has reimbursed UK primary care practices for alcohol screening in people with schizophrenia since April 2011. This study aimed to determine the impact of financial incentives on alcohol screening by comparing rates of alcohol recording in people with versus those without schizophrenia between 2000 and 2013. METHODS: Cross-sectional and retrospective cohort study. Alcohol data were extracted from The Health Improvement Network (THIN) database of UK primary care records using (a) Read Codes for level of alcohol consumption, (b) continuous measures of drinking (e.g. units a week) and (c) Read Codes for types of screening test. RESULTS: A total of 14,860 individuals (54% (8068) men and 46% (6792) women) from 409 general practices aged 18-99 years with schizophrenia were identified during April 2011-March 2013. Of these, 11,585 (78%) had an alcohol record, of which 99% (8150/8257) of Read Codes for level of consumption were eligible for recompense in the QOF. There was an 839% increase in alcohol recording among people with schizophrenia over the 13-year period (rate ratio per annum increase 1.19 (95% CI 1.18-1.20)) compared with a 62% increase among people without a severe mental illness (rate ratio per annum increase 1.04 (95% CI 1.03-1.05)). CONCLUSION: Financial incentives offered by the QOF appear to have a substantial impact on alcohol screening among people with schizophrenia in UK primary care. SHORT SUMMARY: Alcohol screening among people with schizophrenia increased dramatically in primary health care following the introduction of the UK pay for performance incentive scheme (Quality and Outcomes Framework) for severe mental illness, with an 839% rise (>8-fold increase) compared with a 62% increase among people without a over the 13-year study period (2000-2013).

Type: Article
Title: Impact of Financial Incentives on Alcohol Consumption Recording in Primary Health Care Among Adults with Schizophrenia and Other Psychoses: A Cross-Sectional and Retrospective Cohort Study.
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/alcalc/agw076
Publisher version: http://dx.doi.org/10.1093/alcalc/agw076
Language: English
Additional information: Copyright © 2016 Medical Council on Alcoholism. This is a pre-copyedited, author-produced PDF of an article accepted for publication in Alcohol and Alcoholism following peer review. The version of record Nerve Growth Factor Protects Against Alcohol-Induced Neurotoxicity in PC12 Cells via PI3K/Akt/mTOR Pathway Liping Liu, Tiedong Sun, Feng Xin, Wei Cui, Jianquan Guo, Jian Hu Alcohol and Alcoholism Oct 2016, DOI: 10.1093/alcalc/agw07 is available online at: http://alcalc.oxfordjournals.org/content/early/2016/10/18/alcalc.agw077
Keywords: Schizophrenia; Alcohol; Screening; Primary care; QOF
UCL classification: UCL
UCL > Provost and Vice Provost Offices
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
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/1522378
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