Population Intermediate Outcomes of Diabetes Under Pay-for-Performance Incentives in England From 2004 to 2008
Open Access
- 1 March 2009
- journal article
- Published by American Diabetes Association in Diabetes Care
- Vol. 32 (3), 427-429
- https://doi.org/10.2337/dc08-1999
Abstract
OBJECTIVE—To evaluate diabetes outcomes under a national “pay-for-performance” program. RESEARCH DESIGN AND METHODS—Data were analyzed for 98% of all English family practices. For each practice, the proportion of diabetic subjects with A1C ≤7.5%, blood pressure ≤145/85 mmHg, and cholesterol ≤5 mmol/l was determined. Practices achieving less than the 25th centile for the A1C target for 2006–2007 were classified as low performing. RESULTS—The proportion achieving the A1C target at the median practice increased from 59.1% (interquartile range [IQR] 51.7–65.9) in 2004–2005 to 66.7% (IQR 60.6–72.7) in 2007–2008, blood pressure from 70.9% in 2004–2005 to 80.2% in 2007–2008, and cholesterol from 72.6% in 2004–2005 to 83.6% in 2007–2008. In 2004–2005, 57% of practices were low performing (range by region 42.4–69.9). In 2007–2008, 26% of practices were low performing (range 11.6–37.5). CONCLUSIONS—Introduction of pay-for-performance may be one factor contributing to increasing achievement of targets and reducing problems of low performance.Keywords
This publication has 9 references indexed in Scilit:
- Effect of social deprivation on blood pressure monitoring and control in England: a survey of data from the quality and outcomes frameworkBMJ, 2008
- Effect of financial incentives on inequalities in the delivery of primary clinical care in England: analysis of clinical activity indicators for the quality and outcomes frameworkThe Lancet, 2008
- Pay for performance systems in general practice: experience in the United Kingdom.The Medical Journal of Australia, 2008
- Quality of diabetes care in the UK: comparison of published quality‐of‐care reports with results of the Quality and Outcomes Framework for DiabetesDiabetic Medicine, 2007
- Diabetes care and the new GMS contract: the evidence for a whole county.2007
- Achievement of metabolic targets for diabetes by English primary care practices under a new system of incentivesDiabetic Medicine, 2007
- Pay-for-Performance Programs in Family Practices in the United KingdomNew England Journal of Medicine, 2006
- Improvements in quality of clinical care in English general practice 1998-2003: longitudinal observational studyBMJ, 2005
- Linking Physicians' Pay to the Quality of Care — A Major Experiment in the United KingdomNew England Journal of Medicine, 2004