ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2011
Association of practice size and pay-for-performance incentives with the quality of diabetes management in primary care.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 6 of them syntheses that pooled it.
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Who cites it
22 citing papers in PubMed, 6 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
- The role of the Quality and Outcomes Framework in the care of long-term conditions: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2017Pooled it
- Effectiveness of UK provider financial incentives on quality of care: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2017Pooled it
- Payment methods for outpatient care facilities.The Cochrane database of systematic reviews · 2017Pooled it
- The impact of financial incentives on the implementation of asthma or diabetes self-management: A systematic review.PloS one · 2017Pooled it
- Implementation Processes and Pay for Performance in Healthcare: A Systematic Review.Journal of general internal medicine · 2016Pooled it
- Practice context affects efforts to improve diabetes care for primary care patients: a pragmatic cluster randomized trial.Journal of general internal medicine · 2015Trial
- Does the implementation of an incentive scheme increase adherence to diabetes guidelines? A retrospective cohort study of managed care enrollees.BMC health services research · 2023Article
- Examining the Long-term Spillover Effects of a Pay-for-Performance Program in a Healthcare System That Lacks Referral Arrangements.International journal of health policy and management · 2023Article
- Article
- Changes in heart failure management and long-term mortality over 10 years: observational study.Open heart · 2022Observational
- Small practice participation and performance in Medicare accountable care organizations.The American journal of managed care · 2022Article
- The impact of the diabetes management incentive on diabetes-related services: evidence from Ontario, Canada.The European journal of health economics : HEPAC : health economics in prevention and care · 2020Article
- Evaluation of the Diabetes Screening Component of a National Cardiovascular Risk Assessment Programme in England: a Retrospective Cohort Study.Scientific reports · 2020Article
- Pay-for-Performance: Disappointing Results or Masked Heterogeneity?Medical care research and review : MCRR · 2017Review
- Metabolic parameters and blood pressures achieved by diabetic patients at two health care facilities in south Trinidad.Journal of epidemiology and global health · 2015Article
- [Compliance with process indicators in people with type 2 diabetes and linking incentives in Primary Care].Atencion primaria · 2015Observational
- The impact of a diabetes local enhanced service on quality outcome framework diabetes outcomes.PloS one · 2013Article
- Social implications of tight glycemic control.Canadian family physician Medecin de famille canadien · 2012Article
- Association between patient and general practice characteristics and unplanned first-time admissions for cancer: observational study.British journal of cancer · 2012Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundNot enough is known about the association between practice size and clinical outcomes in primary care. We examined this association between 1997 and 2005, in addition to the impact of the Quality and Outcomes Framework, a pay-for-performance incentive scheme introduced in the United Kingdom in 2004, on diabetes management.
methodsWe conducted a retrospective open-cohort study using data from the General Practice Research Database. We enrolled 422 general practices providing care for 154,945 patients with diabetes. Our primary outcome measures were the achievement of national treatment targets for blood pressure, glycated hemoglobin (HbA(1c)) levels and total cholesterol.
resultsWe saw improvements in the recording of process of care measures, prescribing and achieving intermediate outcomes in all practice sizes during the study period. We saw improvement in reaching national targets after the introduction of the Quality and Outcomes Framework. These improvements significantly exceeded the underlying trends in all practice sizes for achieving targets for cholesterol level and blood pressure, but not for HbA(1c) level. In 1997 and 2005, there were no significant differences between the smallest and largest practices in achieving targets for blood pressure (1997 odds ratio [OR] 0.98, 95% confidence interval [CI] 0.82 to 1.16; 2005 OR 0.92, 95% CI 0.80 to 1.06 in 2005), cholesterol level (1997 OR 0.94, 95% CI 0.76 to 1.16; 2005 OR 1.1, 95% CI 0.97 to 1.40) and glycated hemoglobin level (1997 OR 0.79, 95% CI 0.55 to 1.14; 2005 OR 1.05, 95% CI 0.93 to 1.19).
interpretationWe found no evidence that size of practice is associated with the quality of diabetes management in primary care. Pay-for-performance programs appear to benefit both large and small practices to a similar extent.
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