ArticleFamily practice2025
Does pay for performance promote inverse inequality in chronic disease management?
Article in Family practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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.
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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.
- Trends in Potentially Avoidable Hospitalisations Among People With Diabetes in Ireland; 2015-2024.Diabetes, obesity & metabolism · 2026Article
- Leveraging physical activity data in chronic disease management: a novel approach in Irish general practice.Irish journal of medical science · 2026Article
- Factors associated with pneumococcal vaccination uptake in over 50s in Ireland: a cross-sectional study using results from the Irish Longitudinal Study on Ageing (TILDA).BMJ public health · 2026Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn Ireland, a mixed public-private system exists, whereby some patients receive state-funded general practice (GP) care under the General Medical Services (GMS), while private patients (PPs) pay fees. In 2020, the chronic disease management programme was introduced at the practice level to enhance the management of eight conditions. This pay for performance (P4P) programme incentivises GPs to review GMS patients regularly using a structured protocol. It is hypothesized that ineligible PPs receiving 'routine care', receive a poorer standard of care.
objectiveTo investigate the effect of P4P on the standard of care between PPs and GMS patients.
methodsRetrospective cross-sectional study involving 11 GP practices in the Midwest of Ireland. Clinical parameters recorded for the previous 12 months on 25 GMS patients and 25 PPs, matched by age group, sex, and one clinical condition, were collected from each practice. Parameters included vaccination status, and recording of: blood pressure, smoking status, renal function, glycosylated haemoglobin, and lipids.
resultsData from 550 patients showed that GMS patients were more likely than PPs to have received/been offered vaccinations (influenza (66% vs 26%), COVID-19 (69% vs 23%), pneumococcal (59% vs 15%)). GMS patients were more likely than PPs to have other parameters measured: blood pressure (92% vs 54%); smoking status (84% vs 24%); renal function (90% vs 59%); glycated haemoglobin (87% vs 56%); lipids (89% vs 57%) (P < .001 for all parameters).
conclusionSignificant disparities exist in the management of chronic disease in Ireland between GMS patients and PPs. Limiting P4P programmes to GMS patients promotes inequality.
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