ArticleBMJ (Clinical research ed.)2014
Effect of a national primary care pay for performance scheme on emergency hospital admissions for ambulatory care sensitive conditions: controlled longitudinal study.
Article in BMJ (Clinical research ed.), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03355677 (A Clinical Interventional Study Into Airways Disease Case Finding and Complex Case Management), which is not on this map. Cited by 62 papers, 6 of them syntheses that pooled it.
What it found
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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.
A Clinical Interventional Study Into Airways Disease Case Finding and Complex Case Management
Who cites it
62 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Pooled it
- Effect of UK Quality and Outcomes Framework pay-for-performance programme on quality of primary care: systematic review with quantitative synthesis.BMJ (Clinical research ed.) · 2025Pooled it
- Design and effects of outcome-based payment models in healthcare: a systematic review.The European journal of health economics : HEPAC : health economics in prevention and care · 2019Pooled 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
- A systematic review of the magnitude and cause of geographic variation in unplanned hospital admission rates and length of stay for ambulatory care sensitive conditions.BMC health services research · 2015Pooled it
- Pharmaceutical policies: effects of financial incentives for prescribers.The Cochrane database of systematic reviews · 2015Pooled it
- Socioeconomic inequalities in the quality of care for long-term conditions in England: retrospective, observational study of electronic primary care records from the Clinical Practice Research Datalink.Journal of epidemiology and community health · 2026Observational
- Assessment of potentially avoidable hospitalizations in Ningxia, China: application of a China-specific ACSCs list.Frontiers in public health · 2026Article
- An evidence-informed Delphi study of ambulatory care sensitive conditions in China: a policy tool to assess primary care performance.The Lancet regional health. Western Pacific · 2025Article
- Quality and outcomes framework achievement and unplanned admissions for cardiovascular disease.BMC health services research · 2025Article
- Observational
- General practice characteristics associated with pay-for-performance in the UK: a systematic review.BJGP open · 2025Article
- Development of the China's list of ambulatory care sensitive conditions (ACSCs): a study protocol.Global health research and policy · 2024Article
- Exploring the association between primary care efficiency and health system characteristics across European countries: a two-stage data envelopment analysis.BMC health services research · 2023Article
- Changes in Polypharmacy and Potentially Inappropriate Medications in Homebound Older Adults in Japan, 2015-2019: a Nationwide Study.Journal of general internal medicine · 2023Article
- Impact of prevention in primary care on costs in primary and secondary care for people with serious mental illness.Health economics · 2023Article
- Trends in avoidable hospitalizations in a developed City in eastern China: 2015 to 2018.BMC health services research · 2022Article
- Evaluating the Effectiveness of a Local Primary Care Incentive Scheme: A Difference-in-Differences Study.Medical care research and review : MCRR · 2022Article
- Complements or substitutes? Associations between volumes of care provided in the community and hospitals.The European journal of health economics : HEPAC : health economics in prevention and care · 2021Article
- Inequalities in glycemic management in people living with type 2 diabetes mellitus and severe mental illnesses: cohort study from the UK over 10 years.BMJ open diabetes research & care · 2021Article
2 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectiveTo estimate the impact of a national primary care pay for performance scheme, the Quality and Outcomes Framework in England, on emergency hospital admissions for ambulatory care sensitive conditions (ACSCs).
designControlled longitudinal study.
settingEnglish National Health Service between 1998/99 and 2010/11.
participantsPopulations registered with each of 6975 family practices in England.
main outcome measuresYear specific differences between trend adjusted emergency hospital admission rates for incentivised ACSCs before and after the introduction of the Quality and Outcomes Framework scheme and two comparators: non-incentivised ACSCs and non-ACSCs.
resultsIncentivised ACSC admissions showed a relative reduction of 2.7% (95% confidence interval 1.6% to 3.8%) in the first year of the Quality and Outcomes Framework compared with ACSCs that were not incentivised. This increased to a relative reduction of 8.0% (6.9% to 9.1%) in 2010/11. Compared with conditions that are not regarded as being influenced by the quality of ambulatory care (non-ACSCs), incentivised ACSCs also showed a relative reduction in rates of emergency admissions of 2.8% (2.0% to 3.6%) in the first year increasing to 10.9% (10.1% to 11.7%) by 2010/11.
conclusionsThe introduction of a major national pay for performance scheme for primary care in England was associated with a decrease in emergency admissions for incentivised conditions compared with conditions that were not incentivised. Contemporaneous health service changes seem unlikely to have caused the sharp change in the trajectory of incentivised ACSC admissions immediately after the introduction of the Quality and Outcomes Framework. The decrease seems larger than would be expected from the changes in the process measures that were incentivised, suggesting that the pay for performance scheme may have had impacts on quality of care beyond the directly incentivised activities.
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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.