Quality of clinical primary care and targeted incentive payments: an observational study

Steel, Nicholas, Maisey, Susan, Clark, Allan, Fleetcroft, Robert and Howe, Amanda (2007) Quality of clinical primary care and targeted incentive payments: an observational study. British Journal of General Practice, 57 (539). pp. 449-454. ISSN 1478-5242

Full text not available from this repository. (Request a copy)

Abstract

Background: Payments for recorded evidence of quality of clinical care in UK general practices were introduced in 2004. Aim: To examine the relationship between changes in recorded quality of care for four common chronic conditions from, 2003 to 2005, and the payment of incentives. Design of study: Retrospective observational study comparing incentivised and non-incentivised indicators of quality of care. Setting: Eighteen general practices in England. Method: Medical records were examined for 1156 patients. The percentage of eligible quality indicators achieved for each patient was assessed in 2003 and 2005. Twenty-one quality indicators referred to asthma and hypertension: six subject to and 15 not subject to incentive payments. Another 15 indicators referred to depression and osteoarthritis which were not subject to incentive payments. Results: A significant increase occurred for the six indicators linked to incentive payments: from 75% achieved in 2003 to 91% in 2005 (change = 16%, 95% confidence interval [CI] = 10 to 22%, P<0.01). A significant increase also occurred for 15 other indicators linked to ‘incentivised conditions’; 53 to 64% (change = 11%, 95% CI = 6 to 15%, P<0.01). The ‘non-incentivised conditions’ started at a lower achievement level, and did not increase significantly: 35 to 36% (change = 2%, 95% CI = −1 to 4%, P = 0.19). Conclusion: The introduction of financial incentives was associated with substantial apparent quality improvement for incentivised conditions. For non-incentivised conditions, quality did not appear to improve. Patients with non-incentivised conditions may be at risk of poorer quality care.

Item Type:	Article
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023) Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health Faculty of Medicine and Health Sciences > Research Centres > Population Health Faculty of Science > Research Groups > Statistics
Related URLs:	https://bjgp.org/content/57/539/449
Depositing User:	EPrints Services
Date Deposited:	25 Nov 2010 11:11
Last Modified:	28 Mar 2025 03:53
URI:	https://ueaeprints.uea.ac.uk/id/eprint/13776
DOI:

Actions (login required)

View Item