Code list: res43: ckd_kontopantelis

Research article:

Recorded quality of primary care for patients with diabetes in England before and after the introduction of a financial incentive scheme: a longitudinal observational study

Reference:

Evangelos Kontopantelis; David Reeves; Jose M Valderas; Stephen Campbell; Tim Doran (2012) Recorded quality of primary care for patients with diabetes in England before and after the introduction of a financial incentive scheme: a longitudinal observational study. BMJ Quality and Safety, doi: 10.1136/bmjqs-2012-001033

Link to article
Abstract: Background: The UK's Quality and Outcomes Framework (QOF) was introduced in 2004/5, linking remuneration for general practices to recorded quality of care for chronic conditions, including diabetes mellitus. We assessed the effect of the incentives on recorded quality of care for diabetes patients and its variation by patient and practice characteristics. Methods: Using the General Practice Research Database we selected a stratified sample of 148 English general practices in England, contributing data from 2000/1 to 2006/7, and obtained a random sample of 653 500 patients in which 23 920 diabetes patients identified. We quantified annually recorded quality of care at the patient-level, as measured by the 17 QOF diabetes indicators, in a composite score and analysed it longitudinally using an Interrupted Time Series design. Results: Recorded quality of care improved for all subgroups in the pre-incentive period. In the first year of the incentives, composite quality improved over-and-above this pre-incentive trend by 14.2% (13.7–14.6%). By the third year the improvement above trend was smaller, but still statistically significant, at 7.3% (6.7–8.0%). After 3 years of the incentives, recorded levels of care varied significantly for patient gender, age, years of previous care, number of co-morbid conditions and practice diabetes prevalence. Conclusions: The introduction of financial incentives was associated with improvements in the recorded quality of diabetes care in the first year. These improvements included some measures of disease control, but most captured only documentation of recommended aspects of clinical assessment, not patient management or outcomes of care. Improvements in subsequent years were more modest. Variation in care between population groups diminished under the incentives, but remained substantial in some cases.
Author for correspondence: Evangelos Kontopantelis
Email for correspondence: e.kontopantelis@manchester.ac.uk

Code list: res43: ckd_kontopantelis_bmjqs2012

7 codes in list

Code	Coding system	Description	Entity type	List name	qof code	conservative
1Z12.00	Read	Chronic kidney disease stage 3	diagnostic	res43: ckd_kontopantelis_bmjqs2012	yes	yes
1Z13.00	Read	Chronic kidney disease stage 4	diagnostic	res43: ckd_kontopantelis_bmjqs2012	yes	yes
1Z14.00	Read	Chronic kidney disease stage 5	diagnostic	res43: ckd_kontopantelis_bmjqs2012	yes	yes
D215000	Read	Anaemia secondary to chronic renal failure	symptom	res43: ckd_kontopantelis_bmjqs2012		no
K05..00	Read	Chronic renal failure	diagnostic	res43: ckd_kontopantelis_bmjqs2012		yes
Kyu2100	Read	[X]Other chronic renal failure	diagnostic	res43: ckd_kontopantelis_bmjqs2012		yes
5932EC	OXMIS	CHRONIC RENAL FAILURE	diagnostic	res43: ckd_kontopantelis_bmjqs2012		yes

0 comments have been posted.

Please log in to leave a comment.

Quick links:

Code list links:

Only the original uploading author or an administrator can add, edit or delete this article and its associated codes.

ClinicalCodes is a project at the University of Manchester Institute of Population Health

The ClinicalCodes project is funded by the National Institute for Health Research (NIHR) School for Primary Care Research (SPCR)

ClinicalCodes.org