ArticleHealth services research2012
Family doctor responses to changes in incentives for influenza immunization under the U.K. Quality and Outcomes Framework pay-for-performance scheme.
Article in Health services research, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 4 of them syntheses that pooled it.
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Who cites it
20 citing papers in PubMed, 4 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Vaccination in England: a review of why business as usual is not enough to maintain coverage.BMC public health · 2018Pooled 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
- Payment methods for outpatient care facilities.The Cochrane database of systematic reviews · 2017Pooled it
- Implementation Processes and Pay for Performance in Healthcare: A Systematic Review.Journal of general internal medicine · 2016Pooled it
- Construction of an index system for workplace services by family doctors in China: a two-round Delphi study.BMC primary care · 2026Article
- Quality and outcomes framework achievement and unplanned admissions for cardiovascular disease.BMC health services research · 2025Article
- Examining organisational responses to performance-based financial incentive systems: a case study using NHS staff influenza vaccination rates from 2012/2013 to 2019/2020.BMJ quality & safety · 2022Observational
- Beyond Targets: Measuring Better and Rebuilding Trust Comment on "Gaming New Zealand's Emergency Department Target: How and Why Did It Vary Over Time and Between Organisations?"International journal of health policy and management · 2021Article
- Development and Validation of a Clinical Prediction Tool for Seasonal Influenza Vaccination in England.JAMA network open · 2020Article
- Incentivised chronic disease management and the inverse equity hypothesis: findings from a longitudinal analysis of Scottish primary care practice-level data.BMC medicine · 2017Article
- Associations between exemption and survival outcomes in the UK's primary care pay-for-performance programme: a retrospective cohort study.BMJ quality & safety · 2016Article
- How Financial and Reputational Incentives Can Be Used to Improve Medical Care.Health services research · 2015Article
- Impact of the Prevalence of Concordant and Discordant Conditions on the Quality of Diabetes Care in Family Practices in England.Annals of family medicine · 2015Article
- Does the quality and outcomes framework reduce psychiatric admissions in people with serious mental illness? A regression analysis.BMJ open · 2015Article
- Impact of 'stretch' targets for cardiovascular disease management within a local pay-for-performance programme.PloS one · 2015Article
- The future of immunization policies in Italy and in the European Union: The Declaration of Erice.Human vaccines & immunotherapeutics · 2015Article
- Trends in management and outcomes of COPD patients in primary care, 2000-2009: a retrospective cohort study.NPJ primary care respiratory medicine · 2014Article
- Withdrawing performance indicators: retrospective analysis of general practice performance under UK Quality and Outcomes Framework.BMJ (Clinical research ed.) · 2014Article
- Increasing the QOF upper payment threshold in general practices in England: impact of implementing government proposals.The British journal of general practice : the journal of the Royal College of General Practitioners · 2014Article
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Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveTo analyze the effect of setting higher targets, in a primary care pay-for-performance scheme, on rates of influenza immunization and exception reporting. STUDY
settingThe U.K. Quality and Outcomes Framework links financial rewards for family practices to four separate influenza immunization rates for patients with coronary heart disease (CHD), chronic obstructive pulmonary disease, diabetes, and stroke. There is no additional payment for immunization rates above an upper threshold. Patients for whom immunization would be inappropriate can be excepted from the practice for the calculation of the practice immunization rate. DATA: Practice-level information on immunizations and exceptions extracted from electronic records of all practices in England 2004/05 to 2009/10 (n=8,212-8,403). STUDY
designLongitudinal random effect multilevel linear regressions comparing changes in practice immunization and exception rates for the four chronic conditions before and after the increase in the upper threshold immunization rate for CHD patients in 2006/07. PRINCIPAL
findingsThe 5 percent increase in the upper payment threshold for CHD was associated with increases in the proportion of immunized CHD patients (0.41 percent, CI: 0.25-0.56 percent), and exception was reported (0.26 percent, CI: 0.12-0.40 percent).
conclusionsMaking quality targets more demanding can not only lead to improvement in quality of care but can also have other consequences.
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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.