Improving the Recording of Diagnoses in Primary Care with Team Incentives: A Controlled Longitudinal Follow-Up Study

Autor: Marko Raina, Lasse Suominen, Reijo Sund, Tuomo Lehtovuori, Anna Maria Heikkinen, Jouko Kallio, Timo Kauppila
Přispěvatelé: Department of General Practice and Primary Health Care, Clinicum, University of Helsinki, Department of Oral and Maxillofacial Diseases, Research Units of the Faculty of Social Sciences, Centre for Social Data Science, CSDS, Department of Social Research (2010-2017), HUS Head and Neck Center
Jazyk: angličtina
Rok vydání: 2018
Předmět:
medicine.medical_specialty
Article Subject
ENGLAND
Primary health care
lcsh:Medicine
Primary care
030204 cardiovascular system & hematology
General Biochemistry
Genetics and Molecular Biology
Interrupted Time Series Analysis
03 medical and health sciences
0302 clinical medicine
GLYCEMIC CONTROL
Diabetes Mellitus
medicine
QUALITY
Humans
Longitudinal Studies
030212 general & internal medicine
Medical diagnosis
Retrospective Studies
Patient Care Team
OUTCOMES
Primary Health Care
General Immunology and Microbiology
business.industry
ICD
lcsh:R
Follow up studies
General Medicine
PERFORMANCE
3. Good health
Incentive
Chronic disease
3121 General medicine
internal medicine and other clinical medicine
Chronic Disease
Emergency medicine
TRIAL
Observational study
PAY
business
Research Article
Follow-Up Studies
Zdroj: BioMed Research International, Vol 2018 (2018)
BioMed Research International
ISSN: 2314-6141
2314-6133
Popis: Introduction. We studied whether primary care teams respond to financial group bonuses by improving the recording of diagnoses, whether this intervention leads to diagnoses reflecting the anticipated distribution of diseases, and how the recording of a significant chronic disease, diabetes, alters after the application of these bonuses. Methods. We performed an observational register-based retrospective quasi-experimental follow-up study with before-and-after setting and two control groups in primary healthcare of a Finnish town. We studied the rate of recorded diagnoses in visits to general practitioners with interrupted time series analysis. The distribution of these diagnoses was also recorded. Results. After group bonuses, the rate of recording diagnoses increased by 17.9% (95% CI: 13.6–22.3) but not in either of the controls (−2.0 to −0.3%). The increase in the rate of recorded diagnoses in the care teams varied between 14.9% (4.7–25.2) and 33.7% (26.6–41.3). The distribution of recorded diagnoses resembled the respective distribution of diagnoses in the former studies of diagnoses made in primary care. The rate of recorded diagnoses of diabetes did not increase just after the intervention. Conclusions. In primary care, the completeness of diagnosis recording can be, to varying degrees, influenced by group bonuses without guarantee that recording of clinically significant chronic diseases is improved.
Databáze: OpenAIRE
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