ArticleBMJ (Clinical research ed.)2015
Investigating the relationship between quality of primary care and premature mortality in England: a spatial whole-population study.
Article in BMJ (Clinical research ed.), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 2 of them syntheses that pooled it.
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
53 citing papers in PubMed, 2 syntheses or guidelines pooled it, 100 citations in OpenAlex.
- What drives general practitioners in the UK to improve the quality of care? A systematic literature review.BMJ open quality · 2021Pooled it
- Effects of pay-for-performance for primary care physicians on diabetes outcomes in single-payer health systems: a systematic review.The European journal of health economics : HEPAC : health economics in prevention and care · 2019Pooled it
- The Effect of Financial Incentives on Quality Measures in the Treatment of Diabetes Mellitus: a Randomized Controlled Trial.Journal of general internal medicine · 2022Trial
- Payment mechanisms to improve prevention spending in health care settings: A policy-focused evidence brief.Public health in practice (Oxford, England) · 2026Article
- Early Enrollment in Diabetes Pay-for-Performance Program Reduced Loss of Life Expectancy in Newly-Diagnosed Patients with Type 2 Diabetes Mellitus.Diabetes & metabolism journal · 2025Article
- Opting out of the Quality and Outcomes Framework (QOF) and impact on practices' performance.Public health in practice (Oxford, England) · 2024Article
- Does shortage of GPs matter? A cross-sectional study of practice population life expectancy.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- Article
- Do social media interventions increase vaccine uptake?Frontiers in public health · 2023Article
- Development of office-hours use of primary health centers in the early years of the 21International journal of circumpolar health · 2022Observational
- Evaluating the Effectiveness of a Local Primary Care Incentive Scheme: A Difference-in-Differences Study.Medical care research and review : MCRR · 2022Article
- Article
- Excess mortality, COVID-19 and health care systems in Canada.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2022Article
- Article
- How do they measure up? Differences in stakeholder perceptions of quality measures used in English community nursing.Journal of health services research & policy · 2020Article
- Improving primary care management of asthma: do we know what really works?NPJ primary care respiratory medicine · 2020Review
- Evaluation of the Diabetes Screening Component of a National Cardiovascular Risk Assessment Programme in England: a Retrospective Cohort Study.Scientific reports · 2020Article
- Prevalence of mental illness in primary care and its association with deprivation and social fragmentation at the small-area level in England.Psychological medicine · 2020Article
- Relationship between general practice capitation funding and the quality of primary care in England: a cross-sectional, 3-year study.BMJ open · 2019Article
- Article
Corrections and comments
- Commented on by
- Commented on by
- Commented on by
- Commented on by
Authors and funding
6 authors at 6 institutions in 2 countries.
Funding
Abstract
objectivesTo quantify the relationship between a national primary care pay-for-performance programme, the UK's Quality and Outcomes Framework (QOF), and all-cause and cause-specific premature mortality linked closely with conditions included in the framework.
designLongitudinal spatial study, at the level of the "lower layer super output area" (LSOA).
setting32482 LSOAs (neighbourhoods of 1500 people on average), covering the whole population of England (approximately 53.5 million), from 2007 to 2012.
participants8647 English general practices participating in the QOF for at least one year of the study period, including over 99% of patients registered with primary care.
interventionNational pay-for-performance programme incentivising performance on over 100 quality-of-care indicators.
main outcome measuresAll-cause and cause-specific mortality rates for six chronic conditions: diabetes, heart failure, hypertension, ischaemic heart disease, stroke, and chronic kidney disease. We used multiple linear regressions to investigate the relationship between spatially estimated recorded quality of care and mortality.
resultsAll-cause and cause-specific mortality rates declined over the study period. Higher mortality was associated with greater area deprivation, urban location, and higher proportion of a non-white population. In general, there was no significant relationship between practice performance on quality indicators included in the QOF and all-cause or cause-specific mortality rates in the practice locality.
conclusionsHigher reported achievement of activities incentivised under a major, nationwide pay-for-performance programme did not seem to result in reduced incidence of premature death in the population.
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.