Dementia Diagnostics in Primary Care: A Representative 8-Year Follow-Up Study in Lower Saxony, Germany

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.

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Clinical and radiological predictors for persistent complaints five years after a lateral ankle sprain: A long-term follow-up study in primary care

Journal of Science and Medicine in Sport ◽

10.1016/j.jsams.2017.07.005 ◽

2018 ◽

Vol 21 (3) ◽

pp. 250-256 ◽

Cited By ~ 11

Author(s):

Adinda K.E. Mailuhu ◽

Edwin H.G. Oei ◽

Nienke van Putte-Katier ◽

John M. van Ochten ◽

Patrick J.E. Bindels ◽

...

Keyword(s):

Primary Care ◽

Ankle Sprain ◽

Lateral Ankle Sprain ◽

Lateral Ankle ◽

Follow Up Study ◽

Long Term Follow Up

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Changes in secondary pharmacological prevention of acute coronary syndromes and stroke after hospital discharge: a 6-month follow-up study of German primary care patients

Journal of Public Health ◽

10.1007/s10389-008-0210-0 ◽

2008 ◽

Vol 17 (1) ◽

pp. 3-7 ◽

Cited By ~ 2

Author(s):

Sabine Loeffert ◽

Oliver Ommen ◽

Nicole Ernstmann ◽

Holger Pfaff

Keyword(s):

Primary Care ◽

Hospital Discharge ◽

Acute Coronary Syndromes ◽

Follow Up Study ◽

Pharmacological Prevention ◽

Primary Care Patients ◽

Coronary Syndromes

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Financial team incentives improved recording of diagnoses in primary care: a quasi-experimental longitudinal follow-up study with controls

BMC Research Notes ◽

10.1186/s13104-015-1602-1 ◽

2015 ◽

Vol 8 (1) ◽

Cited By ~ 4

Author(s):

Tuomo Lehtovuori ◽

Timo Kauppila ◽

Jouko Kallio ◽

Marko Raina ◽

Lasse Suominen ◽

...

Keyword(s):

Primary Care ◽

Follow Up Study ◽

Quasi Experimental

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Usefulness of Home Screening for Promoting Awareness of Impaired Glycemic Status and Utilization of Primary Care in a Low Socio-Economic Setting: A Follow-Up Study in Reunion Island

International Journal of Health Policy and Management ◽

10.34172/ijhpm.2021.114 ◽

2021 ◽

Author(s):

Adrian Fianu ◽

Éric Doussiet ◽

Nadège Naty ◽

Sylvaine Porcherat ◽

Corinne Mussard ◽

...

Keyword(s):

Primary Care ◽

Diabetes Prevention ◽

Healthcare Access ◽

Primary Objective ◽

Reunion Island ◽

Glycemic Status ◽

Literacy Interventions ◽

Follow Up Study ◽

Réunion Island

Background: Low socio-economic settings are characterized by high prevalence of diabetes and difficulty in accessing healthcare. In these contexts, proximity health services could improve healthcare access for diabetes prevention. Our primary objective was to evaluate the usefulness of home screening for promoting awareness of impaired glycemic status and utilization of primary care among adults aged 18-79 in a low socio-economic setting. Methods: This follow-up study was conducted in 2015-2016 in Reunion Island, a French overseas department in the Indian Ocean. Enrollment and screening occurred on the same day at the home of participants (N=907). Impaired glycemic status was defined as [glycated hemoglobin (HbA1c) ≥5.7%] OR [fasting capillary blood glucose (FCBG) ≥1.10 g/L] OR [HbA1c=5.5-5.6% and FCBG=1.00-1.09 g/L]. Medical, socio-cultural, and socio-economic characteristics were collected via a face-to-face questionnaire. A one-month telephone follow-up survey was conducted to determine whether participants had consulted a general practitioner (GP) for confirmation of screening results. A multinomial polytomous logistic regression model was used to identify factors independently associated with non-use of GP consultation for confirmation of screening results and nonresponse to the telephone follow-up survey. Results: Prevalence of glycemic abnormalities was 46.0% (95% CI = 42.7-49.2%). Among participants with impaired glycemic status (N=417), 77.7% (95% CI=73.7-81.7%) consulted a GP for confirmation of screening results, 12.5% (95% CI=9.3-15.6%) did not, and 9.8% failed to respond to the follow-up survey. Factors independently associated with non-use of GP consultation for confirmation of screening results were self-reported unwillingness to consult a GP (adjusted odds ratio [OR]: 4.86, 95% CI=1.70-13.84), usual GP consultation frequency of less than once a year (adjusted OR: 4.13, 95% CI=1.56-10.97), and age 18-39 years (adjusted OR: 3.09, 95% CI=1.46-6.57). Conclusion: Home screening for glycemic abnormalities is a useful proximity health service for diabetes prevention in low socio-economic settings. Further efforts, including health literacy interventions, are needed to increase utilization of primary care.

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