ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2006
Practice size and quality attainment under the new GMS contract: a cross-sectional analysis.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 5 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- The Role of Physician and Practice Characteristics in the Quality of Diabetes Management in Primary Care: Systematic Review and Meta-analysis.Journal of general internal medicine · 2020Pooled it
- Design and effects of outcome-based payment models in healthcare: a systematic review.The European journal of health economics : HEPAC : health economics in prevention and care · 2019Pooled it
- Implementation Processes and Pay for Performance in Healthcare: A Systematic Review.Journal of general internal medicine · 2016Pooled it
- The equity dimension in evaluations of the quality and outcomes framework: a systematic review.BMC health services research · 2011Pooled it
- Systematic review: Effects, design choices, and context of pay-for-performance in health care.BMC health services research · 2010Pooled it
- The Association Between Panel Size and Health Outcomes of Patients with Hypertension in Urban China: a Population-Based Retrospective Cohort Study.Journal of general internal medicine · 2021Article
- Article
- Impact of electronic diabetes registry 'Meaningful Use' on quality of care and hospital utilization.Journal of the American Medical Informatics Association : JAMIA · 2016Article
- Article
- Article
- Performance of small general practices under the UK's Quality and Outcomes Framework.The British journal of general practice : the journal of the Royal College of General Practitioners · 2010Article
- Nurse staffing and quality of care in UK general practice: cross-sectional study using routinely collected data.The British journal of general practice : the journal of the Royal College of General Practitioners · 2010Article
- Do the Quality and Outcomes Framework patient experience indicators reward practices that offer improved access?The British journal of general practice : the journal of the Royal College of General Practitioners · 2009Article
- Developing performance indicators for primary care: Walsall's experience.The British journal of general practice : the journal of the Royal College of General Practitioners · 2008Article
- Impact of the 2004 GMS contract on practice nurses: a qualitative study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2008Article
- Impact of practice size on delivery of diabetes care before and after the Quality and Outcomes Framework implementation.The British journal of general practice : the journal of the Royal College of General Practitioners · 2008Article
- Practice postcode versus patient population: a comparison of data sources in England and Scotland.International journal of health geographics · 2008Article
- Dismantling general practice.The British journal of general practice : the journal of the Royal College of General Practitioners · 2007Article
- GPs with special interests: unanswered questions.The British journal of general practice : the journal of the Royal College of General Practitioners · 2007Article
- Practice size, caseload, deprivation and quality of care of patients with coronary heart disease, hypertension and stroke in primary care: national cross-sectional study.BMC health services research · 2007Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Quality and Outcomes Framework (QOF) of the new General Medical Services contract, for the first time, incentivises certain areas of general practice workload over others. The ability of practices to deliver high quality care may be related to the size of the practice itself.
aimTo explore the relationship between practice size and points attained in the QOF. DESIGN OF STUDY: Cross-sectional analyses of routinely available data.
settingUrban general practice in mainland Scotland.
methodQOF points and disease prevalence were obtained for all urban general practices in Scotland (n = 638) and linked to data on the practice, GP and patient population. The relationship between QOF point attainment, disease prevalence and practice size was examined using univariate statistical analyses.
resultsSmaller practices were more likely to be located in areas of socioeconomic deprivation; had patients with poorer health; and were less likely to participate in voluntary practice-based quality schemes. Overall, smaller practices received fewer QOF points compared to larger practices (P = 0.003), due to lower point attainment in the organisational domain (P = 0.002). There were no differences across practice size in the other domains of the QOF, including clinical care. Smaller practices reported higher levels of chronic obstructive pulmonary disease (COPD) and mental health conditions and lower levels of asthma, epilepsy and hypothyroidism. There was no difference in the reported prevalence of hypertension or coronary heart disease (CHD) across practices, in contrast to CHD mortality for patients aged under 70 years, where the mortality rate was 40% greater for single-handed practices compared with large practices.
conclusionsAlthough smaller practices obtained fewer points than larger practices under the QOF, this was due to lower scores in the organisational domain of the contract rather than to lower scores for clinical care. Single-handed practices, in common with larger practices serving more deprived populations, reported lower than expected CHD prevalence in their practice populations. Our results suggest that smaller practices continue to provide clinical care of comparable quality to larger practices but that they may need increased resources or support, particularly in the organisational domain, to address unmet need or more demanding QOF criteria.
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Identifiers
17132349PMC1927090What OpenQuestion holds
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.