Pay-for-performance in the United Kingdom: Impact of the quality and outcomes framework-a systematic review

Annals of Family Medicine

Volumn 10, Issue 5, 2012, Pages 461-468

  Gillam, Stephen J ^a   Niroshan Siriwardena, A ^b   Steel, Nicholas ^c  

^a UNIVERSITY OF CAMBRIDGE   (United Kingdom)

^b UNIVERSITY OF LINCOLN   (United Kingdom)

^c UNIVERSITY OF EAST ANGLIA   (United Kingdom)

Author keywords

General practice; Incentive; Pay for performance; Primary care; Quality improvement; Quality of health care; Reimbursement; Review; Systematic

Indexed keywords

COST BENEFIT ANALYSIS; ECONOMICS; HEALTH CARE DISPARITY; HEALTH CARE QUALITY; HUMAN; METHODOLOGY; PATIENT CARE; PATIENT SATISFACTION; PRIMARY HEALTH CARE; REIMBURSEMENT; REVIEW; STATISTICS; TOTAL QUALITY MANAGEMENT; UNITED KINGDOM;

COST-BENEFIT ANALYSIS; GREAT BRITAIN; HEALTHCARE DISPARITIES; HUMANS; PATIENT CARE TEAM; PATIENT SATISFACTION; PRIMARY HEALTH CARE; QUALITY IMPROVEMENT; QUALITY OF HEALTH CARE; REIMBURSEMENT, INCENTIVE;

EID: 84861834916     PISSN: 15441709     EISSN: 15441717     Source Type: Journal    
DOI: 10.1370/afm.1377     Document Type: Review

References (66)

1. Starfield B, Shi L, Macinko J. Contribution of primary care to health systems and health. Milbank Q. 2005;83(3):457-502.
2. Roland M. Linking physicians' pay to the quality of care-a major experiment in the United kingdom. N Engl J Med. 2004;351(14): 1448-1454.
3. Siriwardena AN. Should the quality and outcomes framework be abolished? No. BMJ. 2010;340:c2794.
4. NHS Employers. Quality and outcomes framework. http://www.nhsemployers. org/PayAndContracts/GeneralMedicalServicesContract/QOF/Pages/QualityOutcomesFramework.aspx.
5. NHS Employers. Quality and Outcomes Framework guidance for GMS contract 2011/12. Delivering investment in general practice. NHS Employers. April 2011. http://www.nhsemployers.org/Aboutus/Publications/Documents/QOF_guidance_GMS_contract_2011_12.pdf.
6. The NHS Information Centre, Prescribing and Primary Care Services. Quality and Outcomes Framework Achievement Data 2009-2010. The NHS Information Centre for Health and Social Care; 2010. http://www.ic.nhs.uk/statistics-and-data-collections/audits-and-performance/the-quality-and-outcomes-framework.
7. Van Herck P, De Smedt D, Annemans L, Remmen R, Rosenthal MB, Sermeus W. Systematic review: Effects, design choices, and context of pay-for-performance in health care. BMC Health Serv Res. 2010;10:247.
8. Annemans L, Boeckxstaens P, Borgermans L, et al. Voordelen, nadelen en haalbaarheid van het invoeren van 'Pay for Quality' programma's in België [Advantages, disadvantages and feasibility of the introduction of 'Pay for Quality' programmes in Belgium]. KCE report 118A & supplement 118S ed. 2009. Brussels, Federaal Kenniscentrum voor de Gezondheidszorg (Belgian Health Care Knowledge Centre). https://kce.fgov.be/sites/default/files/page_documents/d20091027353_1.pdf.
9. Christianson JB, Leatherman S, Sutherland K. Financial Incentives, Healthcare Providers and Quality Improvements. A Review of the Evidence. London, The Health Foundation; 2007.
10. Greene SE, Nash DB. Pay for performance: an overview of the literature. Am J Med Qual. 2009;24(2):140-163.
11. Steel N, Willems S. Research learning from the UK Quality and Outcomes Framework: a review of existing research. Qual Prim Care. 2010;18(2):117-125.
12. Petersen LA, Woodard LD, Urech T, Daw C, Sookanan S. Does payfor- performance improve the quality of health care? Ann Intern Med. 2006;145(4):265-272.
13. Town R, Kane R, Johnson P, Butler M. Economic incentives and physicians' delivery of preventive care: a systematic review. Am J Prev Med. 2005;28(2):234-240.
14. Armour BS, Pitts MM, Maclean R, et al. The effect of explicit financial incentives on physician behavior. Arch Intern Med. 2001;161(10): 1261-1266.
15. Scott A, Sivey P, Ait Ouakrim D, et al. The effect of financial incentives on the quality of health care provided by primary care physicians. Cochrane Database Syst Rev. 2011;9:CD008451.
16. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.
17. Donabedian A. Evaluating the quality of medical care. Milbank Mem Fund Q. 1966:44(3):Suppl:166-206.
18. Maxwell RJ. Quality assessment in health. Br Med J (Clin Res Ed). 1984;288(6428):1470-1472.
19. Campbell SM, Roland MO, Buetow SA. Defining quality of care. Soc Sci Med. 2000;51(11):1611-1625.
20. Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Press; 2001.
21. Gillam S, Siriwardena AN. The quality and outcomes framework: triumph of evidence or tragedy for personal care? In: Gillam S, Siriwardena AN, eds. The Quality and Outcomes Framework: QOF Transforming General Practice. Oxford: Radcliffe Publishing Ltd; 2010: 156-166.
22. Doran T, Kontopantelis E, Valderas JM, et al. Effect of financial incentives on incentivised and non-incentivised clinical activities: longitudinal analysis of data from the UK Quality and Outcomes Framework. BMJ. 2011;342:d3590.
23. MacBride-Stewart SP, Elton R, Walley T. Do quality incentives change prescribing patterns in primary care? An observational study in Scotland. Fam Pract. 2008;25(1):27-32.
24. Steel N, Willems S. Learning from the QOF: a review of existing research. In: Gillam S, Siriwardena AN, eds. The Quality and Outcomes Framework: QOF Transforming General Practice. Oxford: Radcliffe Publishing Ltd; 2010;31-69.
25. Martin S, Smith PC, Dusheiko M, Gravelle H. Do Improvements in Primary Care Reduce Secondary Care Costs? London: The Health Foundation; 2010.
26. Fleetcroft R, Parekh-Bhurke S, Howe A, Cookson R, Swift L, Steel N. The UK pay-for-performance programme in primary care: estimation of population mortality reduction. Br J Gen Pract. 2010;60(578): e345-e352.
27. Shohet C, Yelloly J, Bingham P, Lyratzopoulos G. The association between the quality of epilepsy management in primary care, general practice population deprivation status and epilepsy-related emergency hospitalisations. Seizure. 2007;16(4):351-355.
28. Fleetcroft R, Parekh-Bhurke S, Howe A, Cookson R, Swift L, Steel N. The UK pay-for-performance programme in primary care: estimation of population mortality reduction. Br J Gen Pract. 2010;60(578): e345-e352.
29. Walker S, Mason AR, Claxton K, et al. Value for money and the Quality and Outcomes Framework in primary care in the UK NHS. Br J Gen Pract. 2010;60(574):e213-e220.
30. Fleetcroft R, Parekh-Bhurke S, Howe A, Cookson R, Swift L, Steel N. The UK pay-for-performance programme in primary care: estimation of population mortality reduction. Br J Gen Pract. 2010;60(578): e345-e352.
31. Walker S, Mason AR, Claxton K, et al. Value for money and the Quality and Outcomes Framework in primary care in the UK NHS. Br J Gen Pract. 2010;60(574):e213-e220.
32. Doran T, Fullwood C, Kontopantelis E, Reeves D. Effect of financial incentives on inequalities in the delivery of primary clinical care in England: analysis of clinical activity indicators for the quality and outcomes framework. Lancet. 2008;372(9640):728-736.
33. Millett C, Gray J, Wall M, Majeed A. Ethnic disparities in coronary heart disease management and pay for performance in the UK. J Gen Intern Med. 2009;24(1):8-13.
34. Fleetcroft R, Steel N, Cookson R, Howe A. "Mind the gap!" Evaluation of the performance gap attributable to exception reporting and target thresholds in the new GMS contract: National database analysis. BMC Health Serv Res. 2008;8:131.
35. Campbell SM, Kontopantelis E, Reeves D, et al. Changes in patient experiences of primary care during health service reforms in England between 2003 and 2007. Ann Fam Med. 2010;8(6):499-506.
36. Campbell SM, Kontopantelis E, Reeves D, et al. Changes in patient experiences of primary care during health service reforms in England between 2003 and 2007. Ann Fam Med. 2010;8(6):499-506.
37. Grant S, Huby G, Watkins F, et al. The impact of pay-for-performance on professional boundaries in UK general practice: an ethnographic study. Sociol Health Illn. 2009;31(2):229-245.
38. Maisey S, Steel N, Marsh R, Gillam S, Fleetcroft R, Howe A. Effects of payment for performance in primary care: qualitative interview study. J Health Serv Res Policy. 2008;13(3):133-139.
39. Campbell SM, McDonald R, Lester H. The experience of pay for performance in English family practice: a qualitative study. Ann Fam Med. 2008;6(3):228-234.
40. Maisey S, Steel N, Marsh R, Gillam S, Fleetcroft R, Howe A. Effects of payment for performance in primary care: qualitative interview study. J Health Serv Res Policy. 2008;13(3):133-139.
41. Checkland K, Harrison S. The impact of the Quality and Outcomes Framework on practice organisation and service delivery: summary of evidence from two qualitative studies. Qual Prim Care. 2010;18 (2):139-146.
42. Campbell SM, McDonald R, Lester H. The experience of pay for performance in English family practice: a qualitative study. Ann Fam Med. 2008;6(3):228-234.
43. Apekey TA, McSorley G, Tilling M, Siriwardena AN. Room for improvement? Leadership, innovation culture and uptake of quality improvement methods in general practice. J Eval Clin Pract. 2011;17 (2):311-318.
44. Gillam S, Siriwardena AN. The Quality and Outcomes Framework: QOF Transforming General Practice. Oxford: Radcliffe Publishing Ltd; 2010.
45. Dixon A, Khachatryan A. A review of the public health impact of the Quality and Outcomes Framework. Qual Prim Care. 2010;18(2): 133-138.
46. Morrison J, Anderson MJ, Sutton M, et al. Factors influencing variation in prescribing of antidepressants by general practices in Scotland. Br J Gen Pract. 2009;59(559):e25-e31.
47. Alabbadi I, Crealey G, Turner K, et al. Statin prescribing in Northern Ireland and England pre and post introduction of the quality and outcomes framework. Pharm World Sci. 2010;32(1):43-51.
48. Cupples ME, Byrne MC, Smith SM, Leathem CS, Murphy AW. Secondary prevention of cardiovascular disease in different primary healthcare systems with and without pay-for-performance. Heart. 2008;94(12):1594-1600.
49. Checkland K, Harrison S, McDonald R, Grant S, Campbell S, Guthrie B. Biomedicine, holism and general medical practice: responses to the 2004 general practitioner contract. Sociol Health Illn. 2008;30 (5):788-803.
50. Wilkie P. Does the patient always benefit? In: Gillam S, Siriwardena AN, eds. The Quality and Outcomes Framework: QOF Transforming General Practice. Oxford: Radcliffe Publishing Ltd; 2010:128-136.
51. Starfield B, Mangin D. An international perspective on the basis forf payment-for-performance. In: Gillam S, Siriwardena AN (eds). The Quality and Outcomes Framework: QOF Transforming General Practice. Oxford: Radcliffe Publishing Ltd; 2010:147-155.
52. Dixon-Woods M, Agarwal S, Jones D, Young B, Sutton A. Synthesising qualitative and quantitative evidence: a review of possible methods. J Health Serv Res Policy. 2005;10(1):45-53.
53. Kordowicz M, Ashworth M. 'Smoke and mirrors'? Informatics opportunities and challenges. In: Gillam S, Siriwardena AN, eds. The Quality and Outcomes Framework: QOF Transforming General Practice. Oxford: Radcliffe Publishing Ltd; 2010:82-92.
54. Mant J, Hicks N. Detecting differences in quality of care: the sensitivity of measures of process and outcome in treating acute myocardial infarction. BMJ. 1995;311(7008):793-796.
55. McDonald R, Roland M. Pay for performance in primary care in England and California: comparison of unintended consequences. Ann Fam Med. 2009;7(2):121-127.
56. Ariely D, Gneezy U, Loewenstein G, Mazar N. Large stakes and big mistakes. Rev Econ Stud. 2009;76(2):451-469.
57. McDonald R, Roland M. Pay for performance in primary care in England and California: comparison of unintended consequences. Ann Fam Med. 2009;7(2):121-127.
58. Marshall M, Harrison S. It's about more than money: financial incentives and internal motivation. Qual Saf Health Care. 2005;14(1):4-5.
59. Shekelle P. New contract for general practitioners. BMJ. 2003;326 (7387):457-458.
60. Lester H, Roland M. Future of quality measurement. BMJ. 2007;335 (7630):1130-1131.
61. Reeves D, Doran T, Valderas JM et al. How to identify when a performance indicator has run its course. BMJ. 2010:340: c1717.
62. Lester H, Schmittdiel J, Selby J et al. The impact of removing financial incentives from clinical quality indicators: longitudinal analysis of four Kaiser Permanente indicators. BMJ. 2010:340: c1898.
63. Campbell S, Lester H. Developing indicators and the concept of QOF ability. In: Gillam S, Siriwardena AN, eds. The Quality and Outcomes Framework: QOF Transforming General Practice. Oxford: Radcliffe Publishing Ltd; 2010:16-30.
64. Gravelle H, Sutton M, Ma A. Doctor Behaviour Under a Pay-forperformance Contract: Evidence From the Quality and Outcomes Framework. CHE Research Paper 28. 2007. York: Centre for Health Economics; 2010.
65. Doran T, Fullwood C, Reeves D, Gravelle H, Roland M. Exclusion of patients from pay-for-performance targets by English physicians. N Engl J Med. 2008;359(3):274-284.
66. Fleetcroft R, Parekh-Bhurke S, Howe A, Cookson R, Swift L, Steel N. The UK pay-for-performance programme in primary care: estimation of population mortality reduction. Br J Gen Pract. 2010;60(578): e345-e352.