| Performance of small general practices under the UK's Quality and Outcomes Framework. | |
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MedLine Citation:
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PMID: 20849683 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Small general practices are often perceived to provide worse care than larger practices. AIM: To describe the comparative performance of small practices on the UK's pay-for-performance scheme, the Quality and Outcomes Framework. DESIGN OF STUDY: Longitudinal analysis (2004-2005 to 2006-2007) of quality scores for 48 clinical activities. SETTING: Family practices in England (n = 7502). METHOD: Comparison of performance of practices by list size, in terms of points scored in the pay-for-performance scheme, reported achievement rates, and population achievement rates (which allow for patients excluded from the scheme). RESULTS: In the first year of the pay-for-performance scheme, the smallest practices (those with fewer than 2000 patients) had the lowest median reported achievement rates, achieving the clinical targets for 83.8% of eligible patients. Performance generally improved for practices of all sizes over time, but the smallest practices improved at the fastest rate, and by year 3 had the highest median reported achievement rates (91.5%). This improvement was not achieved by additional exception reporting. There was more variation in performance among small practices than larger ones: practices with fewer than 3000 patients (20.1% of all practices in year 3), represented 46.7% of the highest-achieving 5% of practices and 45.1% of the lowest-achieving 5% of practices. CONCLUSION: Small practices were represented among both the best and the worst practices in terms of achievement of clinical quality targets. The effect of the pay-for-performance scheme appears to have been to reduce variation in performance, and to reduce the difference between large and small practices. |
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Authors:
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Tim Doran; Stephen Campbell; Catherine Fullwood; Evangelos Kontopantelis; Martin Roland |
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Publication Detail:
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Type: Journal Article; Multicenter Study |
Journal Detail:
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Title: The British journal of general practice : the journal of the Royal College of General Practitioners Volume: 60 ISSN: 1478-5242 ISO Abbreviation: Br J Gen Pract Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-09-20 Completed Date: 2011-02-23 Revised Date: 2011-09-13 |
Medline Journal Info:
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Nlm Unique ID: 9005323 Medline TA: Br J Gen Pract Country: England |
Other Details:
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Languages: eng Pagination: e335-44 Citation Subset: IM |
Affiliation:
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National Primary Care Research and Development Centre, University of Manchester, Manchester. tim.doran@manchester.ac.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Delivery of Health Care
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standards England Family Practice / standards* Health Facility Size / statistics & numerical data Humans Outcome Assessment (Health Care) Quality Indicators, Health Care |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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