ArticleFamily practice2009
A comparison of chronic illness care quality in US and UK family medicine practices prior to pay-for-performance initiatives.
Article in Family practice, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The equity dimension in evaluations of the quality and outcomes framework: a systematic review.BMC health services research · 2011Pooled it
- Assessing quality of care of elderly patients using the ACOVE quality indicator set: a systematic review.PloS one · 2011Pooled it
- Using primary care databases for addiction research: An introduction and overview of strengths and weaknesses.Addictive behaviors reports · 2022Review
- The "cost" of treating to target: cross-sectional analysis of patients with poorly controlled type 2 diabetes in Australian general practice.BMC family practice · 2013Article
- Quality of care for chronic diseases in a British cohort of long-term cancer survivors.Annals of family medicineArticle
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundThe Quality and Outcomes Framework (QOF) has contributed to modest improvements in chronic illness care in the UK. US policymakers have proposed similar pay-for-performance (P4P) approaches to improve care. Since previous studies have not compared chronic illness care quality in US and UK primary care practices prior to the QOF, the relative preparedness of practices to respond to P4P incentives is unknown.
objectiveTo compare US and UK practices on P4P measures prior to program implementation.
methodsWe analysed medical record data collected before QOF implementation from randomly selected patients with diabetes or coronary artery disease (CAD) in 42 UK and 55 US family medicine practices. We compared care processes and intermediate outcomes using hierarchical logistic regression.
resultsWhile we found gaps in chronic illness care quality across both samples, variation was lower in UK practices. UK patients were more likely to receive recommended care processes for diabetes [odds ratio (OR), 8.94; 95% confidence interval (CI), 4.26-18.74] and CAD (OR, 9.18; 95% CI, 5.22-16.17) but less likely to achieve intermediate diabetes outcome targets (OR, 0.50; 95% CI, 0.39-0.64).
conclusionsFollowing National Health Service (NHS) investment in primary care preparedness, but prior to the QOF, UK practices provided more standardized care but did not achieve better intermediate outcomes than a sample of typical US practices. US policymakers should focus on reducing variation in care documentation to ensure the effectiveness of P4P efforts while the NHS should focus on moving from process documentation to better patient outcomes.
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Registered trials
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