TY - JOUR
T1 - Assessing the uptake of incentivised physical health checks for people with serious mental illness
T2 - a cohort study in primary care
AU - Matias, Maria Ana
AU - Jacobs, Rowena
AU - Aragón, María José
AU - Fernandes, Luis
AU - Gutacker, Nils
AU - Siddiqi, Najma
AU - Kasteridis, Panagiotis
N1 - Copyright © 2024, The Authors.
PY - 2024/7/1
Y1 - 2024/7/1
N2 - BACKGROUND: People with serious mental illness are more likely to experience physical illnesses. The onset of many of these illnesses can be prevented if detected early. Physical health screening for people with serious mental illness is incentivised in primary care in England through the Quality and Outcomes Framework (QOF). GPs are paid to conduct annual physical health checks on patients with serious mental illness, including checks of body mass index (BMI), cholesterol, and alcohol consumption. AIM: To assess the impact of removing and reintroducing QOF financial incentives on uptake of three physical health checks (BMI, cholesterol, and alcohol consumption) for patients with serious mental illness. DESIGN AND SETTING: Cohort study using UK primary care data from the Clinical Practice Research Datalink between April 2011 and March 2020. METHOD: A difference-in-difference analysis was employed to compare differences in the uptake of physical health checks before and after the intervention, accounting for relevant observed and unobserved confounders. RESULTS: An immediate change was found in uptake after physical health checks were removed from, and after they were added back to, the QOF list. For BMI, cholesterol, and alcohol checks, the overall impact of removal was a reduction in uptake of 14.3, 6.8, and 11.9 percentage points, respectively. The reintroduction of BMI screening in the QOF increased the uptake by 10.2 percentage points. CONCLUSION: This analysis supports the hypothesis that QOF incentives lead to better uptake of physical health checks.
AB - BACKGROUND: People with serious mental illness are more likely to experience physical illnesses. The onset of many of these illnesses can be prevented if detected early. Physical health screening for people with serious mental illness is incentivised in primary care in England through the Quality and Outcomes Framework (QOF). GPs are paid to conduct annual physical health checks on patients with serious mental illness, including checks of body mass index (BMI), cholesterol, and alcohol consumption. AIM: To assess the impact of removing and reintroducing QOF financial incentives on uptake of three physical health checks (BMI, cholesterol, and alcohol consumption) for patients with serious mental illness. DESIGN AND SETTING: Cohort study using UK primary care data from the Clinical Practice Research Datalink between April 2011 and March 2020. METHOD: A difference-in-difference analysis was employed to compare differences in the uptake of physical health checks before and after the intervention, accounting for relevant observed and unobserved confounders. RESULTS: An immediate change was found in uptake after physical health checks were removed from, and after they were added back to, the QOF list. For BMI, cholesterol, and alcohol checks, the overall impact of removal was a reduction in uptake of 14.3, 6.8, and 11.9 percentage points, respectively. The reintroduction of BMI screening in the QOF increased the uptake by 10.2 percentage points. CONCLUSION: This analysis supports the hypothesis that QOF incentives lead to better uptake of physical health checks.
KW - cohort studies
KW - England
KW - mental illness
KW - physical health checks
KW - primary health care
KW - uptake
UR - http://www.scopus.com/inward/record.url?scp=85197362309&partnerID=8YFLogxK
U2 - 10.3399/BJGP.2023.0532
DO - 10.3399/BJGP.2023.0532
M3 - Article
C2 - 38331443
SN - 0960-1643
VL - 74
SP - e449-e455
JO - The British journal of general practice : the journal of the Royal College of General Practitioners
JF - The British journal of general practice : the journal of the Royal College of General Practitioners
IS - 744
ER -