Long-term evidence for the effect of pay-for-performance in primary care on mortality in the UK: a population study

Ryan, Andrew M.; Krinsky, Sam; Kontopantelis, Evangelos; Doran, Timothy

doi:10.1016/s0140-6736(16)00276-2

Cited by 118 publications

(106 citation statements)

References 35 publications

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“…Furthermore, reanalysis of the data suggested not only that the initial reduction was not statistically significant but also that mortality rates for nonincentivized conditions increased (62). Similarly, mortality rates for conditions not incentivized under the QOF increased in the United Kingdom relative to other countries during the early years of the scheme, although this increase was not statistically significant (86).…”

Section: Introductionmentioning

confidence: 93%

“…Recent studies examining the impact of QOF on mortality found no clear association between practice performance and mortality rates (61) or any apparent benefit to the United Kingdom in terms of reduced mortality for incentivized conditions (86). This evidence comes despite a nationwide, multibillion pound scheme that focused specifically on secondary prevention for several major chronic diseases.…”

Section: Introductionmentioning

confidence: 99%

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Impact of Provider Incentives on Quality and Value of Health Care

Doran

Maurer

Ryan

2017

Annu. Rev. Public Health

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The use of financial incentives to improve quality in health care has become widespread. Yet evidence on the effectiveness of incentives suggests that they have generally had limited impact on the value of care and have not led to better patient outcomes. Lessons from social psychology and behavioral economics indicate that incentive programs in health care have not been effectively designed to achieve their intended impact. In the United States, Medicare's Hospital Readmission Reduction Program and Hospital ValueBased Purchasing Program, created under the Affordable Care Act (ACA), provide evidence on how variations in the design of incentive programs correspond with differences in effect. As financial incentives continue to be used as a tool to increase the value and quality of health care, improving the design of programs will be crucial to ensure their success.

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Section: Introductionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Impact of Provider Incentives on Quality and Value of Health Care

Doran

Maurer

Ryan

2017

Annu. Rev. Public Health

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“…The present research suggests that QOF's commodification process is an important unintended consequence, which further questions its continuity (Checkland et al, 2008;Ryan et al, 2016). For instance, the NHS Scotland has substituted QOF entirely by "quality circles" schemes.…”

Section: Discussionmentioning

confidence: 78%

The Quality and Outcomes Framework: Body commodification in UK general practice

Norman¹,

Russell

Merli

2016

Social Science & Medicine

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Additional information:Use policyThe full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-pro t purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. programme. These environments provided the opportunity for studying various spaces such as QOF meetings, consultation rooms, QOF recoding sessions, and the collection of computer-screen images depicting how patients' biomarkers are evaluated and costed through software systems. QOF as a biomedical technology has led to the commodification of patients and their bodies. This complex phenomenon breaks down into three main themes: commodification of patients, QOF as currency, and valuing commodities. Despite the ostensible aim of QOF being to improve healthcare in general practice, it is accompanied by a body commodification process. The interface between patients and care providers has been commodified, with QOF's pricing mechanism and fragmentation of care provision performing an important role in animating the UK economy.

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“…These programs aim at improving quality and promoting increased access to health services. The Portuguese experiences of 2008 [4][5][6][7][8] and British experience of 2004 and 2010 [9][10][11][12][13][14] have suggested positive conclusions and indicated some precautions in the application of this strategy, and improvement of the initial results of the contractualized goals was noted. These authors alert to the need to change the agreed indicators every two or three years, to avoid ethical biases with what is called "gaming", that is, the focus of the health teams in achieving contractualized goals and paying less attention to other non-contractual aspects.…”

Section: In Item (Iv)mentioning

confidence: 99%