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BACKGROUND In 2004, after a series of national initiatives associated with marked improvements in the quality of care, the National Health Service of the United Kingdom introduced a pay-for-performance contract for family practitioners. This contract increases existing income according to performance with respect to 146 quality indicators covering clinical(More)
BACKGROUND In the English pay-for-performance program, physicians use a range of criteria to exclude individual patients from the quality calculations that determine their pay. This process, which is called exception reporting, is intended to safeguard patients against inappropriate treatment by physicians seeking to maximize their income. However,(More)
BACKGROUND The quality and outcomes framework is a financial incentive scheme that remunerates general practices in the UK for their performance against a set of quality indicators. Incentive schemes can increase inequalities in the delivery of care if practices in affluent areas are more able to respond to the incentives than are those in deprived areas.(More)
OBJECTIVE The Chronic Disease Self-Management Programme (CDSMP) has been shown to be clinically and cost effective; however the specific mechanisms by which benefits are achieved are not well understood. We investigate what aspects of the course are associated with different outcomes. METHODS Post-hoc analysis of data from participants in a randomised(More)
The aim of this study was to conduct a comprehensive systematic review comparing tissue glue (TG) against tacks/staples for mesh fixation in laparoscopic (totally extra-peritoneal and trans-abdominal pre-peritoneal) groin hernia repair with the incidence of post-operative chronic pain as the primary outcome measure. A computerized search of MEDLINE, EMBASE,(More)
OBJECTIVE To investigate the association between indicators of quality of diabetic management in English family practices and emergency hospital admissions for short-term complications of diabetes. STUDY SETTING A total of 8,223 English family practices from 2001/2002 to 2006/2007. STUDY DESIGN Multiple regression analyses of associations between(More)
OBJECTIVE To examine the reasons why practices exempt patients from the UK Quality and Outcomes Framework pay for performance scheme (exception reporting) and to identify the characteristics of general practices associated with informed dissent. DESIGN Retrospective analysis. SETTING Data for 2008-9 extracted from the clinical computing systems of(More)
OBJECTIVE To determine the effectiveness of an intervention to enhance self management support for patients with chronic conditions in UK primary care. DESIGN Pragmatic, two arm, cluster randomised controlled trial. SETTING General practices, serving a population in northwest England with high levels of deprivation. PARTICIPANTS 5599 patients with a(More)
BACKGROUND Increasing the effective targeting and promotion of self-care support for long-term conditions requires more of a focus on patient contexts and networks. The aim of this paper is to describe how within a programme of research and implementation, social networks are viewed as being centrally involved in the mobilisation and deployment of resources(More)
AIMS To examine the utility of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) in the early diagnosis of cardiac implantable electronic device (CIED) generator pocket infection. METHODS AND RESULTS A total of 86 patients with CIEDs were evaluated with (18)F-FDG PET/CT imaging: 46 with suspected generator pocket(More)