Quality and Outcomes Framework Research This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Financial incentives improve recognition but not treatment of cardiovascular risk factors in severe mental illness
This study aimed to assess the QOF ’s impact on detection and treatment of cardiovascular risk factors in people with SMI. MethodsA retrospective open cohort study of UK general practice was conducted between 1996 and 2014, using segmented logistic regression with 2004 and 2011 as break points, reflecting the introduction of relevant QOF incentives in these years. 67239 SMI cases and 359951 randomly-selected unmatched controls were extracted from the Clinical Practice Research Datalink (CPRD). ResultsThere was strong evidence (p ≤0.015) the 2004 QOF indicator (general health) resulted in an immediate increase in record...
Source: PLoS One - June 9, 2017 Category: Biomedical Science Authors: Carol L. Wilson Source Type: research

The Effects of Environmental Factors on the Efficiency of Clinical Commissioning Groups in England: A Data Envelopment Analysis
This study estimates the technical efficiency of 208 CCGs in England using DEA. The inputs and outputs used include budget allocation, number of general practitioners, mortality rates, patient satisfaction and Quality and Outcomes Framework achievement scores. Regression analysis is used to assess the effects of environmental factors on efficiency, such as population size, prevalence of disease, and socio-economic status. Twenty-three percent (47/208) of CCGs were efficient compared to the others. Three environmental factors were statistically significant predictors of efficiency: CCGs with smaller population sizes were mo...
Source: Journal of Medical Systems - May 9, 2017 Category: Information Technology Source Type: research

Trends in the diagnosis and management of hypertension: repeated primary care survey in South West England.
CONCLUSION: In primary care BP monitoring has devolved from GPs and nurses to HCAs. One in 10 practices are not implementing NICE guidelines on ABPM and HBPM for diagnosis of hypertension. Most practices express confidence interpreting HBPM results but less so with ABPM. The need for education and quality assurance for allied health professionals is highlighted, and for training in ABPM interpretation for GPs. PMID: 28347984 [PubMed - as supplied by publisher] (Source: The British Journal of General Practice)
Source: The British Journal of General Practice - March 27, 2017 Category: Primary Care Authors: Mejzner N, Clark CE, Smith LF, Campbell JL Tags: Br J Gen Pract Source Type: research

Pay for performance and contractual choice: the case of general practitioners in England
The Quality and Outcomes Framework (QOF) is a Pay-for-Performance scheme introduced in England in 2004 to reward primary care providers. This incentive scheme provides financial incentives that reward the over... (Source: Health Economics Review)
Source: Health Economics Review - January 31, 2017 Category: Health Management Authors: Eleonora Fichera and Mario Pezzino Source Type: research

Pay for performance and contractual choice: the case of general practitioners in England
AbstractThe Quality and Outcomes Framework (QOF) is a Pay-for-Performance scheme introduced in England in 2004 to reward primary care providers. This incentive scheme provides financial incentives that reward the overall performance of a practice, not individual effort. Consequently, an important question is how the QOF may affect contractual choices, quality provision and doctor mobility in the primary healthcare labour market. The paper provides a simple theoretical model that shows that the introduction and further strengthening of the scheme may have induced practices to compete for the best doctors and modified their ...
Source: Health Economics Review - January 30, 2017 Category: Global & Universal Source Type: research

The epidemiology of teaching and training General Practices in England.
Authors: Rees EL, Gay SP, McKinley RK Abstract There is no national picture of teaching and training practices or the communities they serve. We aimed to describe the association between general practices' engagement with education and their characteristics, locality and patients' health-status and satisfaction. This data linkage study of all English practices calculated odds ratios for teaching and training status and practice, locality and patient variables. Teaching and training practices are larger than practices which do neither (mean list size (SD) 7074 (3736), 10112 (4934), and 5327 (3368) respectiv...
Source: Education for Primary Care - December 23, 2016 Category: Primary Care Tags: Educ Prim Care Source Type: research

Does the proportion of pay linked to performance affect the job satisfaction of general practitioners?
Publication date: Available online 24 November 2016 Source:Social Science & Medicine Author(s): Thomas Allen, William Whittaker, Matthew Sutton There is concern that pay-for-performance (P4P) can negatively affect general practitioners (GPs) by reducing their autonomy, increasing their wage dispersion or eroding their intrinsic motivation. This is especially a concern for the Quality and Outcomes Framework (QOF), a highly powered P4P scheme for UK GPs. The QOF affected all GPs but the exposure of their income to P4P varied. GPs did not know their level of exposure before the QOF was introduced and could not ch...
Source: Social Science and Medicine - November 23, 2016 Category: Psychiatry & Psychology Source Type: research

Older people remain on blood pressure agents despite being hypotensive resulting in increased mortality and hospital admission
Conclusions the results demonstrate that low SBP is associated with adverse events, it is possible that the pursuit of BP control at a population level may lead to over-treatment in certain groups of patients. This may result in an increased incidence of adverse events particularly in older people. (Source: Age and Ageing)
Source: Age and Ageing - November 10, 2016 Category: Geriatrics Authors: Morrissey, Y., Bedford, M., Irving, J., Farmer, C. K. T. Tags: Research paper Source Type: research

Change in COPD cases having QoF reviews in KSS region, UK
Conclusion: In KSS from 2011/12 to 2014/15 there has been a 10.5% increase in the number of COPD patients entered on GP registers and a significant reduction in QoF exceptions. We believe these are important changes which have led to 8,845 additional patients receiving COPD reviews in primary care. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 7, 2016 Category: Respiratory Medicine Authors: Congleton, J., Bott, J. Tags: 1.6 General Practice and Primary Care Source Type: research

Older people remain on blood pressure agents despite being hypotensive resulting in increased mortality and hospital admission
Conclusions</div>the results demonstrate that low SBP is associated with adverse events, it is possible that the pursuit of BP control at a population level may lead to over-treatment in certain groups of patients. This may result in an increased incidence of adverse events particularly in older people.</span> (Source: Age and Ageing)
Source: Age and Ageing - November 1, 2016 Category: Geriatrics Source Type: research

Impact of Financial Incentives on Alcohol Consumption Recording in Primary Health Care Among Adults with Schizophrenia and Other Psychoses: A Cross-Sectional and Retrospective Cohort Study
Conclusion</div>Financial incentives offered by the QOF appear to have a substantial impact on alcohol screening among people with schizophrenia in UK primary care.<div class="boxTitle">Short summary</div>Alcohol screening among people with schizophrenia increased dramatically in primary health care following the introduction of the UK pay for performance incentive scheme (Quality and Outcomes Framework) for severe mental illness, with an 839% rise (>8-fold increase) compared with a 62% increase among people without a over the 13-year study period (2000–2013).</span> (Source: Alcohol and Alcoholism)
Source: Alcohol and Alcoholism - October 12, 2016 Category: Addiction Source Type: research

The role of cost-effectiveness analysis in the development of indicators to support incentive-based behaviour in primary care in England
We describe the development of the methods used to assess the cost-effectiveness of these pay-for-performance indicators and how they have contributed to the development of new indicators. Prior to analysis of new potential indicators, an economic subgroup of the National Institute for Health and Care Excellence (NICE) Indicator Advisory Committee is formed to assess evidence on the cost-effectiveness of potential indicators in terms of the health benefits gained, compared to the cost of the intervention and the cost of the incentive. The expert subgroup is convened to reach consensus on the amounts that could potentially ...
Source: Journal of Health Services Research and Policy - September 27, 2016 Category: Health Management Authors: Qureshi, N., Weng, S., Hex, N. Tags: Essay Source Type: research

Associations between exemption and survival outcomes in the UK's primary care pay-for-performance programme: a retrospective cohort study
Conclusions Older, multimorbid and more deprived patients are more likely to be exempted from the scheme. Exception reported patients are more likely to die in the following year, whether they are exempted by the practice for a contraindication or by themselves through informed dissent. Further research is needed to understand the relationship between exception reporting and patient outcomes. (Source: BMJ Quality and Safety)
Source: BMJ Quality and Safety - August 16, 2016 Category: Journals (General) Authors: Kontopantelis, E., Springate, D. A., Ashcroft, D. M., Valderas, J. M., van der Veer, S. N., Reeves, D., Guthrie, B., Doran, T. Tags: Open access, BMJQS Noteworthy articles Original research Source Type: research

Should doctors be able to exclude patients from pay-for-performance schemes?
In 2004, the UK introduced what was at the time the world's most ambitious pay-for-performance scheme, the Quality and Outcomes Framework or ‘QOF’. Twenty five per cent of general practitioners’ (GPs’) pay was tied to a complex set of 136 quality indicators, the majority of which were extracted electronically from GPs’ medical records.1 Typical indicators related to blood pressure control in hypertension or blood sugar control in patients with diabetes. However, GPs were given the opportunity to exclude patients from these quality calculations, and this was called exception reporting. If a GP ...
Source: BMJ Quality and Safety - August 16, 2016 Category: Journals (General) Authors: Roland, M. Tags: BMJQS Noteworthy articles Editorials Source Type: research

Do changes to Quality and Outcomes Framework diabetes clinical indicators affect care as measured in the National Diabetes Audit?
This article is protected by copyright. All rights reserved. (Source: Diabetic Medicine)
Source: Diabetic Medicine - July 31, 2016 Category: Endocrinology Authors: R. Gadsby, B. Young Tags: Letter Source Type: research