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Research article:
Effect of financial incentives on incentivised and non-incentivised clinical activities: longitudinal analysis of data from the UK Quality and Outcomes Framework
Reference:
Doran, Tim; Kontopantelis, Evangelos; Valderas, Jose M; Campbell, Stephen; Roland, Martin; Salisbury, Chris; Reeves, David(2011) Effect of financial incentives on incentivised and non-incentivised clinical activities: longitudinal analysis of data from the UK Quality and Outcomes Framework. British Medical Journal, doi: 10.1136/bmj.d3590
- Link to fulltext article
- Abstract
- Objective: To investigate whether the incentive scheme for UK general practitioners led them to neglect activities not included in the scheme. Design: Longitudinal analysis of achievement rates for 42 activities (23 included in incentive scheme, 19 not included) selected from 428 identified indicators of quality of care. Setting: 148 general practices in England (653 500 patients). Main outcome measures: Achievement rates projected from trends in the pre-incentive period (2000-1 to 2002-3) and actual rates in the first three years of the scheme (2004-5 to 2006-7). Results: Achievement rates improved for most indicators in the pre-incentive period. There were significant increases in the rate of improvement in the first year of the incentive scheme (2004-5) for 22 of the 23 incentivised indicators. Achievement for these indicators reached a plateau after 2004-5, but quality of care in 2006-7 remained higher than that predicted by pre-incentive trends for 14 incentivised indicators. There was no overall effect on the rate of improvement for non-incentivised indicators in the first year of the scheme, but by 2006-7 achievement rates were significantly below those predicted by pre-incentive trends. Conclusions: There were substantial improvements in quality for all indicators between 2001 and 2007. Improvements associated with financial incentives seem to have been achieved at the expense of small detrimental effects on aspects of care that were not incentivised.
- Author for correspondence
- Tim Doran
- Email for correspondence
- tim.doran@york.ac.uk
Code list: Angiotensin-II receptor antagonists
81 codes in list
| Code | Coding system | Description | Entity type | List name | BNF_header | BNF_code | drug_substance_name |
|---|---|---|---|---|---|---|---|
| 00313001 | GPRD_product_code | MICARDIS PLUS tabs 80mg + 12.5mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 02350001 | GPRD_product_code | OLMETEC tabs 40mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 02748001 | GPRD_product_code | TELMISARTAN + HYDROCHLOROTHIAZIDE tabs 80mg + 12.5mg | drug | Angiotensin-II receptor antagonists | NA | 2020100 | NA |
| 07009001 | GPRD_product_code | TELMISARTAN tabs 40mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 07009002 | GPRD_product_code | TELMISARTAN tabs 80mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 07009003 | GPRD_product_code | TELMISARTAN tabs 20mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 07482001 | GPRD_product_code | COZAAR tabs 50mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 07482002 | GPRD_product_code | COZAAR tabs 25mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 07483001 | GPRD_product_code | LOSARTAN tabs 50mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 07483002 | GPRD_product_code | LOSARTAN tabs 25mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 08126001 | GPRD_product_code | OLMESARTAN MEDOXOMIL tabs 40mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 08127001 | GPRD_product_code | OLMESARTAN MEDOXOMIL tabs 10mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 08131001 | GPRD_product_code | OLMETEC tabs 20mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 08132001 | GPRD_product_code | OLMETEC tabs 10mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 08138001 | GPRD_product_code | OLMESARTAN MEDOXOMIL tabs 20mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 08422001 | GPRD_product_code | HYDROCHLOROTHIAZIDE + LOSARTAN tabs 12.5mg + 50mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 08428001 | GPRD_product_code | AMIAS tabs 2mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 08428002 | GPRD_product_code | AMIAS tabs 4mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 08428003 | GPRD_product_code | AMIAS tabs 8mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 08479001 | GPRD_product_code | LOSARTAN tabs 100mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 08759001 | GPRD_product_code | LOSARTAN + HYDROCHLOROTHIAZIDE tabs 50mg + 12.5mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 08910001 | GPRD_product_code | IRBESARTAN + HYDROCHLOROTHIAZIDE tabs 150mg + 12.5mg | drug | Angiotensin-II receptor antagonists | NA | 2020100 | NA |
| 08910002 | GPRD_product_code | IRBESARTAN + HYDROCHLOROTHIAZIDE tabs 300mg + 12.5mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 09210001 | GPRD_product_code | COZAAR tabs 100mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 09450001 | GPRD_product_code | MICARDIS PLUS tabs 40mg + 12.5mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 09452001 | GPRD_product_code | TELMISARTAN + HYDROCHLOROTHIAZIDE tabs 40mg + 12.5mg | drug | Angiotensin-II receptor antagonists | NA | 2020100 | NA |
| 09495001 | GPRD_product_code | CANDESARTAN tabs 16mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 09496001 | GPRD_product_code | CANDESARTAN tabs 2mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 09496002 | GPRD_product_code | CANDESARTAN tabs 4mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 09496003 | GPRD_product_code | CANDESARTAN tabs 8mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 09567001 | GPRD_product_code | MICARDIS tabs 40mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 09567002 | GPRD_product_code | MICARDIS tabs 80mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 09567003 | GPRD_product_code | MICARDIS tabs 20mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 09922001 | GPRD_product_code | COZAAR-COMP tabs 50mg + 12.5mg | drug | Angiotensin-II receptor antagonists | NA | 2020100 | NA |
| 10485001 | GPRD_product_code | VALSARTAN caps 40mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 10485002 | GPRD_product_code | VALSARTAN caps 80mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 10485003 | GPRD_product_code | VALSARTAN caps 160mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 10486001 | GPRD_product_code | DIOVAN caps 40mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 10486002 | GPRD_product_code | DIOVAN caps 80mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 10486003 | GPRD_product_code | DIOVAN caps 160mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 10707001 | GPRD_product_code | COAPROVEL tabs 150mg + 12.5mg | drug | Angiotensin-II receptor antagonists | NA | 2020100 | NA |
| 10707002 | GPRD_product_code | COAPROVEL tabs 300mg + 12.5mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 10716001 | GPRD_product_code | EPROSARTAN tabs 300mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 10716002 | GPRD_product_code | EPROSARTAN tabs 400mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 10716003 | GPRD_product_code | EPROSARTAN tabs 600mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 10717001 | GPRD_product_code | TEVETEN tabs 300mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 10717002 | GPRD_product_code | TEVETEN tabs 400mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 10717003 | GPRD_product_code | TEVETEN tabs 600mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 11492001 | GPRD_product_code | IRBESARTAN tabs 75mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 11492002 | GPRD_product_code | IRBESARTAN tabs 150mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 11492003 | GPRD_product_code | IRBESARTAN tabs 300mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 11493001 | GPRD_product_code | APROVEL tabs 75mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 11493002 | GPRD_product_code | APROVEL tabs 150mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 11493003 | GPRD_product_code | APROVEL tabs 300mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 11664001 | GPRD_product_code | AMIAS tabs 16mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 12571001 | GPRD_product_code | VALSARTAN + HYDROCHLOROTHIAZIDE tabs 160mg + 12.5mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 12572001 | GPRD_product_code | HYDROCHLOROTHIAZIDE + VALSARTAN tabs 12.5mg + 160mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 12573001 | GPRD_product_code | CO-DIOVAN tabs 160mg + 12.5mg | drug | Angiotensin-II receptor antagonists | NA | 2020100 | NA |
| 12575001 | GPRD_product_code | VALSARTAN + HYDROCHLOROTHIAZIDE tabs 160mg + 25mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 12577001 | GPRD_product_code | HYDROCHLOROTHIAZIDE + VALSARTAN tabs 25mg + 160mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 12578001 | GPRD_product_code | CO-DIOVAN tabs 160mg + 25mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 12785001 | GPRD_product_code | VALSARTAN + HYDROCHLOROTHIAZIDE tabs 80mg + 12.5mg | drug | Angiotensin-II receptor antagonists | NA | 2020100 | NA |
| 12786001 | GPRD_product_code | HYDROCHLOROTHIAZIDE + VALSARTAN tabs 12.5mg + 80mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 12787001 | GPRD_product_code | CO-DIOVAN tabs 80mg + 12.5mg | drug | Angiotensin-II receptor antagonists | NA | 2020100 | NA |
| 12846001 | GPRD_product_code | VALSARTAN tabs 40mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 12847001 | GPRD_product_code | DIOVAN tabs 40mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 12971001 | GPRD_product_code | CANDESARTAN tabs 32mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 12972001 | GPRD_product_code | AMIAS tabs 32mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 13477001 | GPRD_product_code | LOSARTAN + HYDROCHLOROTHIAZIDE tabs 100mg + 25mg | drug | Angiotensin-II receptor antagonists | NA | 2020100 | NA |
| 13478001 | GPRD_product_code | HYDROCHLOROTHIAZIDE + LOSARTAN tabs 25mg + 100mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 13479001 | GPRD_product_code | COZAAR-COMP tabs 100mg + 25mg | drug | Angiotensin-II receptor antagonists | NA | 2020100 | NA |
| 13906001 | GPRD_product_code | OLMESARTAN MEDOXOMIL + HYDROCHLOROTHIAZIDE tabs 20mg + 12.5mg | drug | Angiotensin-II receptor antagonists | NA | 2020100 | NA |
| 13907001 | GPRD_product_code | OLMESARTAN MEDOXOMIL + HYDROCHLOROTHIAZIDE tabs 20mg + 25mg | drug | Angiotensin-II receptor antagonists | NA | 2020100 | NA |
| 13909001 | GPRD_product_code | OLMETEC PLUS tabs 20mg + 12.5mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 13910001 | GPRD_product_code | OLMETEC PLUS tabs 20mg + 25mg | drug | Angiotensin-II receptor antagonists | NA | 2020100 | NA |
| 13959001 | GPRD_product_code | HYDROCHLOROTHIAZIDE + OLMESARTAN MEDOXOMIL tabs 25mg + 20mg | drug | Angiotensin-II receptor antagonists | NA | 2020100 | NA |
| 13960001 | GPRD_product_code | HYDROCHLOROTHIAZIDE + OLMESARTAN MEDOXOMIL tabs 12.5mg + 20mg | drug | Angiotensin-II receptor antagonists | NA | 2020100 | NA |
| 14583001 | GPRD_product_code | VALSARTAN (IPU) tabs 80mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 14585001 | GPRD_product_code | VALSARTAN (IPU) tabs 160mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
| 14780001 | GPRD_product_code | IRBESARTAN + HYDROCHLOROTHIAZIDE tabs 300mg + 25mg | drug | Angiotensin-II receptor antagonists | NA | 2020100 | NA |
| 14781001 | GPRD_product_code | COAPROVEL tabs 300mg + 25mg | drug | Angiotensin-II receptor antagonists | NA | 2050502 | NA |
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