ArticleBMJ open2013
Relationship between quality of care and choice of clinical computing system: retrospective analysis of family practice performance under the UK's quality and outcomes framework.
Article in BMJ open, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 35 papers.
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
35 citing papers in PubMed.
- Examining variations in the prevalence of hazardous opioid prescribing across general practices in England: a cross-sectional study.BMJ quality & safety · 2026Article
- We need to create a competitive market for electronic health record systems.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- General practice characteristics associated with pay-for-performance in the UK: a systematic review.BJGP open · 2025Article
- Article
- Article
- Influence of financial and reputational incentives on primary care performance: a longitudinal study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Observational
- Does payment for performance increase performance inequalities across health providers? A case study of Tanzania.Health policy and planning · 2018Article
- Article
- Article
- Who benefits from increased service utilisation? Examining the distributional effects of payment for performance in Tanzania.International journal for equity in health · 2018Article
- Article
- The effect of ambient temperature on type-2-diabetes: case-crossover analysis of 4+ million GP consultations across England.Environmental health : a global access science source · 2017Article
- Incidence, prevalence and mortality of patients with psoriasis: a U.K. population-based cohort study.The British journal of dermatology · 2017Article
- Pay-for-Performance: Disappointing Results or Masked Heterogeneity?Medical care research and review : MCRR · 2017Review
- Variations in achievement of evidence-based, high-impact quality indicators in general practice: An observational study.PloS one · 2017Observational
- Article
- Article
- Associations between exemption and survival outcomes in the UK's primary care pay-for-performance programme: a retrospective cohort study.BMJ quality & safety · 2016Article
- Prescribed opioids in primary care: cross-sectional and longitudinal analyses of influence of patient and practice characteristics.BMJ open · 2016Article
- Comparison of dementia recorded in routinely collected hospital admission data in England with dementia recorded in primary care.Emerging themes in epidemiology · 2016Article
Corrections and comments
- Erratum issuedCorrection.2013
Authors and funding
5 authors.
Funding
Abstract
objectivesTo investigate the relationship between performance on the UK Quality and Outcomes Framework pay-for-performance scheme and choice of clinical computer system.
designRetrospective longitudinal study.
settingData for 2007-2008 to 2010-2011, extracted from the clinical computer systems of general practices in England.
participantsAll English practices participating in the pay-for-performance scheme: average 8257 each year, covering over 99% of the English population registered with a general practice.
main outcome measuresLevels of achievement on 62 quality-of-care indicators, measured as: reported achievement (levels of care after excluding inappropriate patients); population achievement (levels of care for all patients with the relevant condition) and percentage of available quality points attained. Multilevel mixed effects multiple linear regression models were used to identify population, practice and clinical computing system predictors of achievement.
resultsSeven clinical computer systems were consistently active in the study period, collectively holding approximately 99% of the market share. Of all population and practice characteristics assessed, choice of clinical computing system was the strongest predictor of performance across all three outcome measures. Differences between systems were greatest for intermediate outcomes indicators (eg, control of cholesterol levels).
conclusionsUnder the UK's pay-for-performance scheme, differences in practice performance were associated with the choice of clinical computing system. This raises the question of whether particular system characteristics facilitate higher quality of care, better data recording or both. Inconsistencies across systems need to be understood and addressed, and researchers need to be cautious when generalising findings from samples of providers using a single computing system.
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.