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Article: Screening for diabetic retinopathy with different levels of financial incentive in a randomized controlled trial

TitleScreening for diabetic retinopathy with different levels of financial incentive in a randomized controlled trial
Authors
KeywordsDiabetic retinopathy screening
Financial incentive
Uptake
Issue Date2021
PublisherWiley Open Access: Various Creative Commons Licenses. The Journal's web site is located at https://onlinelibrary.wiley.com/journal/20401124
Citation
Journal of Diabetes Investigation, 2021, v. 12 n. 9, p. 1632-1641 How to Cite?
AbstractAims/Introduction: To examine the impact of different levels of financial incentive in terms of fee subsidization on diabetic retinopathy screening in the private primary care setting in Hong Kong. Materials and Methods: All general practitioners working in the private sector and registered in two electronic public databases were invited to participate. Consecutive patients with diabetes mellitus were then recruited by the participating practitioners. The recruited participants were randomly allocated to one of three screening groups with different fee levels (HK$0, HK$150 [US$19], HK$300 [US$39]) in a randomized controlled trial. Screening uptake and severity of diabetic retinopathy detected were compared. Results: Out of 1,688 eligible practitioners, 105 participated and invited 402 patients, with 239 initially agreeing to participate (59.5%). After randomization, 78, 75 and 76 participants in the HK$0, HK$150 and HK$300 fee groups, respectively, reconfirmed their participation and were offered screening at the relevant fee. The uptake of screening was 79.5% (62/78), 81.3% (61/75) and 63.2% (48/76), in the HK$0, HK$150 and HK$300 groups, respectively (P < 0.018). Being in the HK$150 fee group was associated with higher uptake of screening than being in the HK$300 fee group (odds ratio 2.31, P = 0.039). No significant difference was found in the prevalence of any diabetic retinopathy (33.9%, 27.9% and 37.5%, P = 0.378) or sight-threatening diabetic retinopathy (4.8%, 8.2% and 16.7%; P = 0.092) among the groups. Conclusion: A screening fee of HK$150, representing approximately a half subsidy, appears to be as effective in maximizing uptake as a full subsidy (HK$0) and without deterring those at high risk of diabetic retinopathy from screening.
Persistent Identifierhttp://hdl.handle.net/10722/306431
ISSN
2023 Impact Factor: 3.1
2023 SCImago Journal Rankings: 0.997
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLian, JX-
dc.contributor.authorMcGhee, SM-
dc.contributor.authorSo, C-
dc.contributor.authorKwong, ASK-
dc.contributor.authorSum, R-
dc.contributor.authorTsui, WWS-
dc.contributor.authorChao, DVK-
dc.contributor.authorChan, JCH-
dc.date.accessioned2021-10-22T07:34:31Z-
dc.date.available2021-10-22T07:34:31Z-
dc.date.issued2021-
dc.identifier.citationJournal of Diabetes Investigation, 2021, v. 12 n. 9, p. 1632-1641-
dc.identifier.issn2040-1116-
dc.identifier.urihttp://hdl.handle.net/10722/306431-
dc.description.abstractAims/Introduction: To examine the impact of different levels of financial incentive in terms of fee subsidization on diabetic retinopathy screening in the private primary care setting in Hong Kong. Materials and Methods: All general practitioners working in the private sector and registered in two electronic public databases were invited to participate. Consecutive patients with diabetes mellitus were then recruited by the participating practitioners. The recruited participants were randomly allocated to one of three screening groups with different fee levels (HK$0, HK$150 [US$19], HK$300 [US$39]) in a randomized controlled trial. Screening uptake and severity of diabetic retinopathy detected were compared. Results: Out of 1,688 eligible practitioners, 105 participated and invited 402 patients, with 239 initially agreeing to participate (59.5%). After randomization, 78, 75 and 76 participants in the HK$0, HK$150 and HK$300 fee groups, respectively, reconfirmed their participation and were offered screening at the relevant fee. The uptake of screening was 79.5% (62/78), 81.3% (61/75) and 63.2% (48/76), in the HK$0, HK$150 and HK$300 groups, respectively (P < 0.018). Being in the HK$150 fee group was associated with higher uptake of screening than being in the HK$300 fee group (odds ratio 2.31, P = 0.039). No significant difference was found in the prevalence of any diabetic retinopathy (33.9%, 27.9% and 37.5%, P = 0.378) or sight-threatening diabetic retinopathy (4.8%, 8.2% and 16.7%; P = 0.092) among the groups. Conclusion: A screening fee of HK$150, representing approximately a half subsidy, appears to be as effective in maximizing uptake as a full subsidy (HK$0) and without deterring those at high risk of diabetic retinopathy from screening.-
dc.languageeng-
dc.publisherWiley Open Access: Various Creative Commons Licenses. The Journal's web site is located at https://onlinelibrary.wiley.com/journal/20401124-
dc.relation.ispartofJournal of Diabetes Investigation-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectDiabetic retinopathy screening-
dc.subjectFinancial incentive-
dc.subjectUptake-
dc.titleScreening for diabetic retinopathy with different levels of financial incentive in a randomized controlled trial-
dc.typeArticle-
dc.identifier.emailChan, JCH: jonochan@hku.hk-
dc.identifier.authorityMcGhee, SM=rp00393-
dc.identifier.authorityChan, JCH=rp02113-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1111/jdi.13512-
dc.identifier.pmid33484625-
dc.identifier.pmcidPMC8409893-
dc.identifier.scopuseid_2-s2.0-85101172802-
dc.identifier.hkuros329152-
dc.identifier.volume12-
dc.identifier.issue9-
dc.identifier.spage1632-
dc.identifier.epage1641-
dc.identifier.isiWOS:000619762200001-
dc.publisher.placeAustralia-

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