ArticleBJGP open2023
The relationship between Quality and Outcomes Framework scores and socioeconomic deprivation: a longitudinal study.
Article in BJGP open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Investigating a novel population health management system to increase access to healthcare for children: a nested cross-sectional study within a cluster randomised controlled trial.BMJ quality & safety · 2024Trial
- 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
- Value-Based Pricing of Health Services With Health Equity Considerations.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2026Article
- Adjusting primary-care funding by deprivation: a cross-sectional study of Lower layer Super Output Areas in England.BJGP open · 2025Article
- General practice characteristics associated with pay-for-performance in the UK: a systematic review.BJGP open · 2025Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Quality Outcomes Framework (QOF) is a pay incentive scheme in England designed to improve and standardise general practice. QOF attainment has been used as a proxy for primary care quality in previous research.
aimTo investigate whether there is a relationship between socioeconomic deprivation and QOF attainment in primary care in England. DESIGN &
settingRetrospective longitudinal study of primary care providers in England.
methodQOF scores were obtained for individual general practices in England from between 2007-2019 and linked to practice-level Indices of Multiple Deprivation (IMD) scores derived from census data. Beta regression analyses were used to analyse the relationship with either percentage of total QOF attainment or of domain-specific attainment with multivariate analyses, adjusting for additional practice-level demographics. QOF attainment in the most affluent quintile was used as the reference group.
resultsGeneral practices in less deprived areas have consistently outperformed those in more deprived areas in terms of QOF achievement. Initially, the gap between least and most deprived practices decreased, however since 2015 there has been relatively little change in comparative performance. The magnitude of inequality was reduced after adjusting for demographic factors. Of the independent variables analysed, the proportion of patients aged >65 years ('over 65s') had the strongest relationship with QOF attainment.
conclusionThere remains an inequality in primary care quality by socioeconomic deprivation in England, even after accounting for demographic differences.
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