[Indicators of an increase in dementia diagnosis rate in primary care]

In 2013 and 2014 dementia diagnoses in general practitioner (GP) practices dramatically increased, a phenomenon most likely caused by monetary incentives.

Which GP practice-dependent indicators are associated with the increase in dementia diagnoses and are thus decisive factors for the way in which physicians in GP practices respond to monetary incentives?

We performed a retrospective, longitudinal analysis of 856 GP practices. The increase in dementia diagnoses was calculated by comparing the number of newly diagnosed persons with dementia (PWD) per GP practice in 2012 and 2014. The indicators of the ability to respond included in this study were (1) practice size (number of patients treated per year), (2) geriatric focus (number of patients ≥70 years), and (3) willingness to diagnose (number of newly diagnosed PWD in 2012) and treat (number of antidementia prescriptions in 2012). The analysis of the association between the ability to respond and the indicators was performed using logistic regression.

The changes in the number of diagnoses in GP practices differed greatly. The incidence increase was associated with a higher number of patients treated in a practice and a higher number of patients aged 70 years or older.

Physicians in general practices with a larger number of cases, especially of geriatric patients, showed a higher willingness to respond to monetary incentives introduced to improve the care of geriatric patients. Whether these monetary incentives also lead to an improvement in the quality of care and the lives of PWD should be examined in future analyses.