[Sharp increase in newly diagnosed patients with dementia in German primary care practices 2013. Better diagnostic process or monetary incentives?]

Background In 2013, the incidence of patients with dementia (PwD) in primary care practices (PCP) drastically increased.

RESEARCH QUESTIONS: (1) Is the increase also detectable in a subsample, (2) was there a comparable increase in specialist practices (SP), and (3) did the increase affect diagnostics and therapy? Methods We analyzed billing data from 874 PCP and 141 SP (2011 to 2015) pertaining to more than 14,000 PwD/year with regard to the incidence of dementia diagnoses (ICD-10: G30, F01, F03) and antidementia prescriptions. Results The incidence abruptly increased by 47 % (2013) and 73 % (2014) compared to 2012. Proportions of nonspecific and vascular dementia diagnoses increased. Proportions of Alzheimer's and antidementia prescriptions decreased. No comparable developments were observed in SP. Conclusion The drastic incidence increase in 2013 was closely linked to physician- and patient-related economic incentives. Whether a causal relationship existed and what consequences monetary incentives may have for PwD should be further investigated.