ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2016
Accounting for multimorbidity in pay for performance: a modelling study using UK Quality and Outcomes Framework data.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis 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.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.
- Impact of multimorbidity on healthcare costs and utilisation: a systematic review of the UK literature.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021Pooled it
- Cancer care reviews: a guide for primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- Performance management of generalist care for hospitalised multimorbid patients-a scoping review for value-based care.Frontiers in health services · 2023Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe UK Quality and Outcomes Framework (QOF) offers financial incentives to deliver high-quality care for individual diseases, but the single-disease focus takes no account of multimorbidity.
aimTo examine variation in QOF payments for two indicators incentivised in ≥1 disease domain. DESIGN AND
settingModelling study using cross-sectional data from 314 general practices in Scotland.
methodMaximum payments that practices could receive under existing financial incentives were calculated for blood pressure (BP) control and influenza immunisation according to the number of coexisting clinical conditions. Payments were recalculated assuming a single new indicator.
resultsPayment varied by condition (£4.71-£11.08 for one BP control and £2.09-£5.78 for one influenza immunisation). Practices earned more for delivering the same action in patients with multimorbidity: in patients with 2, 3, and ≥4 conditions mean payments were £13.95, £21.92, and £29.72 for BP control, and £7.48, £11.21, and £15.14 for influenza immunisation, respectively. Practices in deprived areas had more multiple incentivised patients. When recalculated so that each incentivised action was only paid for once, all practices received less for BP control: affluent practices received more and deprived practices received less for influenza immunisation.
conclusionFor patients with single conditions, existing QOF payment methods have more than twofold variation in payment for delivering the same process. Multiple payments were common in patients with multimorbidity. A payment method is required that ensures fairness of rewards while maintaining adequate funding for practices based on actual workload.
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