ArticleBMC health services research2011
Does quality of care for hypertension in primary care vary with postcode area deprivation? An observational study.
Article in BMC health services research, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The impact of reimbursement systems on equity in access and quality of primary care: A systematic literature review.BMC health services research · 2016Pooled it
- A comparison of the quality of hypertension management in primary care between Shanghai and Shenzhen: a cohort study of 3196 patients.Medicine · 2015Trial
- Role of health insurance and neighborhood-level social deprivation on hypertension control following the affordable care act health insurance opportunities.Social science & medicine (1982) · 2020Article
- Equity of primary care service delivery for low income "sicker" adults across 10 OECD countries.International journal for equity in health · 2018Article
- A cross-sectional study of the prevalence, awareness, treatment and control of hypertension in Shenzhen, China.BMJ open · 2017Article
- Diabetes in Shenzhen, China: epidemiological investigation and health care challenges.Journal of global health · 2017Article
- Sustained Reduction in Health Disparities Achieved through Targeted Quality Improvement: One-Year Follow-up on a Three-Year Intervention.Health services research · 2015Article
- A Cross-Sectional Comparison of Perceived Quality of Primary Care by Hypertensive Patients in Shanghai and Shenzhen, China.Medicine · 2015Article
- Implementation of pay for performance in primary care: a qualitative study 8 years after introduction.The British journal of general practice : the journal of the Royal College of General Practitioners · 2013Article
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHypertension is a common major risk factor for stroke and coronary heart disease. Little is known about how achievement of financially incentivised and non-incentivised indicators of quality of care varies with deprivation, or about the effect of financial incentives on health inequalities in hypertension. General practices in the UK have received financial incentives for high quality care since 2004. This study set out to assess the variations in achievement of incentivised and non-incentivised quality indicators for hypertension by patient area deprivation, before and after the introduction of financial incentives.
methodsAchievement of 14 quality indicators for hypertension in 304 patient participants in 18 general practices in Norfolk, England was assessed one year before (2003) and one year after (2005) the introduction of financial incentives. Four indicators were incentivised and 10 were non-incentivised. Each participant's postcode was linked to an index of multiple deprivation score.
resultsThe range of achievement of incentivised quality indicators was 65-94% in the least deprived third of participants, and 77-94% in the most deprived third in 2003 and 2005 combined. For non-incentivised indicators, the range was 7-85% in the least deprived and 24-93% in the most deprived third.Achievement of incentivised quality indicators in 2003 and 2005 combined did not vary significantly by area deprivation. Achievement of three of 10 non-incentivised indicators was higher in participants from more deprived postcode areas: providing lifestyle advice (odds ratio 1.34, 95% confidence interval 1.00-1.79), assessment of peripheral vascular disease (1.54, 1.02-2.35) and electrocardiography (1.38, 1.04-1.82).
conclusionsParticipants from more deprived areas received at least the same, and sometimes better, quality of care than those from less deprived areas. Quality of care for hypertension in general practice may not follow the inequitable distribution seen with some other conditions.
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