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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: hormone replacement therapy

18 codes in list

Code Coding system Description Entity type List name analysis
66U..11 Read Hormone replacement therapy diagnostic hormone replacement therapy Main
66U7.00 Read HRT started diagnostic hormone replacement therapy Main
66U8.00 Read HRT side-effects diagnostic hormone replacement therapy Main
66U9.00 Read HRT changed diagnostic hormone replacement therapy Main
66UA.00 Read HRT stopped diagnostic hormone replacement therapy Resolve
66UB.00 Read HRT: unopposed oestrogen diagnostic hormone replacement therapy Main
66uc.00 Read HRT: combined oestrog/progest diagnostic hormone replacement therapy Main
66UC.00 Read HRT: combined oestrog/progest diagnostic hormone replacement therapy Main
66UH.00 Read Hormone replacement therapy bleed pattern - normal diagnostic hormone replacement therapy Main
66UI.00 Read Hormone replacement therapy bleed pattern - abnormal diagnostic hormone replacement therapy Main
66UJ.00 Read Hormone replacement therapy bleed pattern - not relevant diagnostic hormone replacement therapy Main
66UK.00 Read Hormone replacement therapy bleed pattern - no bleeding diagnostic hormone replacement therapy Main
8B64.00 Read Hormone replacement therapy diagnostic hormone replacement therapy Main
8B64000 Read Hormone Replacement Therapy ongoing treatment diagnostic hormone replacement therapy Main
8B64.11 Read Hormone implant - HRT diagnostic hormone replacement therapy Main
8B64.12 Read HRT prophylaxis diagnostic hormone replacement therapy Main
T366 A Read Hormone replacement therapy diagnostic hormone replacement therapy Main
Y44 KA OXMIS INJECTION HORMONE REPLACEMENT THERAPY diagnostic hormone replacement therapy Main

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