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Effect of a national primary care pay for performance scheme on emergency hospital admissions for ambulatory care sensitive conditions: controlled longitudinal study.

Harrison MJ, Dusheiko M, Sutton M, Gravelle H, Doran T, Roland M - BMJ (2014)

Bottom Line: Incentivised ACSC admissions showed a relative reduction of 2.7% (95% confidence interval 1.6% to 3.8%) in the first year of the Quality and Outcomes Framework compared with ACSCs that were not incentivised.The introduction of a major national pay for performance scheme for primary care in England was associated with a decrease in emergency admissions for incentivised conditions compared with conditions that were not incentivised.The decrease seems larger than would be expected from the changes in the process measures that were incentivised, suggesting that the pay for performance scheme may have had impacts on quality of care beyond the directly incentivised activities.

View Article: PubMed Central - PubMed

Affiliation: Manchester Centre for Health Economics, Institute of Population Health, University of Manchester, UK Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, BC, Canada.

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Fig 1 Percentage change in emergency admissions relative to 1998/99 with no adjustment for trend. ACSC=ambulatory care sensitive conditions; QOF=Quality and Outcomes Framework
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fig1: Fig 1 Percentage change in emergency admissions relative to 1998/99 with no adjustment for trend. ACSC=ambulatory care sensitive conditions; QOF=Quality and Outcomes Framework

Mentions: The emergency admission rate before the introduction of the Quality and Outcomes Framework was increasing at a rate of 5.0% per annum (95% confidence interval 4.5% to 5.5%) for non-incentivised ACSCs and 4.2% per annum (3.9% to 4.6%) for non-ACSCs (fig 1 and supplementary table A1). In contrast, the rate of emergency admissions for incentivised ACSCs was increasing at a rate of only 1.7% (1.2% to 2.2%) per annum over the same period.


Effect of a national primary care pay for performance scheme on emergency hospital admissions for ambulatory care sensitive conditions: controlled longitudinal study.

Harrison MJ, Dusheiko M, Sutton M, Gravelle H, Doran T, Roland M - BMJ (2014)

Fig 1 Percentage change in emergency admissions relative to 1998/99 with no adjustment for trend. ACSC=ambulatory care sensitive conditions; QOF=Quality and Outcomes Framework
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4228282&req=5

fig1: Fig 1 Percentage change in emergency admissions relative to 1998/99 with no adjustment for trend. ACSC=ambulatory care sensitive conditions; QOF=Quality and Outcomes Framework
Mentions: The emergency admission rate before the introduction of the Quality and Outcomes Framework was increasing at a rate of 5.0% per annum (95% confidence interval 4.5% to 5.5%) for non-incentivised ACSCs and 4.2% per annum (3.9% to 4.6%) for non-ACSCs (fig 1 and supplementary table A1). In contrast, the rate of emergency admissions for incentivised ACSCs was increasing at a rate of only 1.7% (1.2% to 2.2%) per annum over the same period.

Bottom Line: Incentivised ACSC admissions showed a relative reduction of 2.7% (95% confidence interval 1.6% to 3.8%) in the first year of the Quality and Outcomes Framework compared with ACSCs that were not incentivised.The introduction of a major national pay for performance scheme for primary care in England was associated with a decrease in emergency admissions for incentivised conditions compared with conditions that were not incentivised.The decrease seems larger than would be expected from the changes in the process measures that were incentivised, suggesting that the pay for performance scheme may have had impacts on quality of care beyond the directly incentivised activities.

View Article: PubMed Central - PubMed

Affiliation: Manchester Centre for Health Economics, Institute of Population Health, University of Manchester, UK Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, BC, Canada.

Show MeSH