ReviewThe British journal of general practice : the journal of the Royal College of General Practitioners2010
Value for money and the Quality and Outcomes Framework in primary care in the UK NHS.
Review in The British journal of general practice : the journal of the Royal College of General Practitioners, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- A systematic review on hospital inefficiency in the Eastern Mediterranean Region: sources and solutions.BMC health services research · 2019Pooled it
- Implementation Processes and Pay for Performance in Healthcare: A Systematic Review.Journal of general internal medicine · 2016Pooled it
- Economic evaluation of pay-for-performance in health care: a systematic review.The European journal of health economics : HEPAC : health economics in prevention and care · 2012Pooled it
- Pay-for-performance in the United Kingdom: impact of the quality and outcomes framework: a systematic review.Annals of family medicinePooled it
- Evaluating the impact of an integrated computer-based decision support with person-centered analytics for the management of asthma in primary care: a randomized controlled trial.Journal of the American Medical Informatics Association : JAMIA · 2015Trial
- Harnessing health economic evaluation for policy and practice.Communications medicine · 2026Review
- The Challenges Ahead: Concepts, Analytics, and Ethics of Value-Based Care in Applied Behavior Analysis.Behavior analysis in practice · 2024Review
- Advanced Nurse Practitioner (ANPs) experiences of the Quality and Outcomes Framework (QOF) Scheme: a UK case study.BMJ open · 2024Article
- Impact of prevention in primary care on costs in primary and secondary care for people with serious mental illness.Health economics · 2023Article
- Evaluating the Effectiveness of a Local Primary Care Incentive Scheme: A Difference-in-Differences Study.Medical care research and review : MCRR · 2022Article
- Mapping the Read2/CTV3 controlled clinical terminologies to Phecodes in UK Biobank primary care electronic health records: implementation and evaluation.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2021Article
- Effectiveness of primary care gatekeeping: difference-in-differences evaluation of a pilot scheme in China.BMJ global health · 2020Article
- Article
- Modelling the cost-effectiveness of pay-for-performance in primary care in the UK.BMC medicine · 2018Article
- Variation in anticoagulation for atrial fibrillation between English clinical commissioning groups: an observational study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Observational
- Financial Incentives to Stimulate Integration of Care.International journal of integrated care · 2016Article
- The true impact of the French pay-for-performance program on physicians' benzodiazepines prescription behavior.The European journal of health economics : HEPAC : health economics in prevention and care · 2016Article
- Incentives in Rheumatology: the Potential Contribution of Physician Responses to Financial Incentives, Public Reporting, and Treatment Guidelines to Health Care Sustainability.Current rheumatology reports · 2016Review
- Lessons learnt from a primary care asthma improvement project.NPJ primary care respiratory medicine · 2016Article
- Pay-for-performance and primary care physicians: lessons from the U.K Quality and Outcomes Framework for local incentive schemes.Journal of the Royal Society of Medicine · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
backgroundThe Quality and Outcomes Framework (QOF) is a pioneering attempt to improve the quality of primary care in the UK through the use of financial rewards. Despite its achievements, there are concerns that the QOF may offer poor value for money.
aimTo assess the cost-effectiveness of QOF payments. DESIGN OF STUDY: Economic analysis.
settingEngland, UK.
methodCost-effectiveness evidence was identified for a subset of nine QOF indicators with a direct therapeutic impact. These data were then applied to an analytic framework to determine the conditions under which QOF payments would be cost-effective. This framework was constructed to assess the cost-effectiveness of QOF payments by modelling the incentive structure using cost-effectiveness thresholds of 20 000 and 30 000 UK pounds per quality-adjusted life year (QALY) gained, to represent good value to the NHS. It used 2004/2005 data on the QOF performance of all English primary care practices.
resultsAverage indicator payments ranged from 0.63 to 40.61 UK pounds per patient, and the percentage of eligible patients treated ranged from 63% to 90%. The proportional changes required for QOF payments to be cost-effective varied widely between the indicators. Although most indicators required only a fraction of a 1% change to be cost-effective, for some indicators improvements in performance of around 20% were needed.
conclusionFor most indicators that can be assessed, QOF incentive payments are likely to be a cost-effective use of resources for a high proportion of primary care practices, even if the QOF achieves only modest improvements in care. However, only a small subset of the indicators has been considered, and no account has been taken of the costs of administering the QOF scheme.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.