Pay-for-performance programs in family practices in the United Kingdom.

  title={Pay-for-performance programs in family practices in the United Kingdom.},
  author={Tim Doran and Catherine Fullwood and Hugh Gravelle and David Reeves and Evangelos Kontopantelis and Urara Hiroeh and Martin Roland},
  journal={The New England journal of medicine},
  volume={355 4},
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 care for 10 chronic diseases, organization of care, and patient experience. METHODS We analyzed data extracted automatically from clinical… 

Tables from this paper

Pay for performance in primary care: proceed with caution, pitfalls ahead.

  • B. Hutchison
  • Medicine, Political Science
    Healthcare policy = Politiques de sante
  • 2008
The QOF is a voluntary program that provides financial incentives for general practices to meet performance criteria in four domains: clinical, organizational, patient experience and additional services, which were chosen and weighted based on the prevalence and illness burden of the target conditions.

Relationship between quality of care and choice of clinical computing system: retrospective analysis of family practice performance under the UK's quality and outcomes framework

Under the UK's pay-for-performance scheme, differences in practice performance were associated with the choice of clinical computing system, raising the question of whether particular system characteristics facilitate higher quality of care, better data recording or both.

The Experience of Pay for Performance in English Family Practice: A Qualitative Study

The QOF scheme may have achieved its declared objectives of improving disease-specific processes of patient care through the achievement of clinical and organizational targets and increased physician income, but the findings suggest that it has changed the dynamic between doctors and nurses and the nature of the practitioner-patient consultation.

Evaluation of the relationship between a chronic disease care management program and california pay-for-performance diabetes care cholesterol measures in one medical group.

A retrospective database review of electronic laboratory values, medical and hospital claims, and encounter data collected between january 1, 2003 and December 31, 2004 at 1 California medical group comprising 160 multispecialty providers assess the potential effect of CDCM on the quality performance ranking and financial reimbursement of a medical group reporting these measures in the 2004 California P4P measurement year.

Pay for Performance in Health Care: Methods and Approaches

This chapter reviews issues regarding the application of quality measures in P4P programs, including conceptual frameworks for quality of care, and reviews organizations that develop and certify quality measures.

Pay for Performance in Primary Care: The Use of Administrative Data by Health Economists

The purpose of this chapter is to report how researchers in health economics and management have benefited from the linkage of several administrative datasets to measure the performance and analyse

Pay for Performance: An Overview of the Literature

  • Stuart E. GreeneD. Nash
  • Medicine, Political Science
    American journal of medical quality : the official journal of the American College of Medical Quality
  • 2009
This annotated bibliography is to offer a critical analysis of the current literature and an overview of the topic of P4P to educate the reader about a health care issue that may become a cornerstone of the payment system.

Changes in Patient Experiences of Primary Care During Health Service Reforms in England Between 2003 and 2007

There was a modest improvement in access to care for patients with chronic illness, but all patients now find it somewhat harder to obtain continuity of care.

Quality of Disease Management and Risk of Mortality in English Primary Care Practices.

It is suggested that a 1 percent improvement in the quality of stroke care could reduce the annual number of deaths in England by 782 and a longer study period may be necessary to detect any mortality impact of better management of other conditions.



Early experience with pay-for-performance: from concept to practice.

Paying clinicians to reach a common, fixed performance target may produce little gain in quality for the money spent and will largely reward those with higher performance at baseline.

The quality of health care delivered to adults in the United States.

The deficits the authors have identified in adherence to recommended processes for basic care pose serious threats to the health of the American public and strategies to reduce these deficits in care are warranted.

Linking physicians' pay to the quality of care--a major experiment in the United kingdom.

  • M. Roland
  • Medicine, Economics
    The New England journal of medicine
  • 2004
A major pay-for-performance program that is being implemented in the United Kingdom where family practitioners can earn up to 1050 quality bonus points for performing well on a complex set of indicators that measure the quality of clinical care.

What makes British general practitioners take part in a quality improvement scheme?

Good teamworking was essential to successful completion of the project and often improved as a result of taking part, and lessons are drawn for future quality improvement programmes in the National Health Service.

Improvements in quality of clinical care in English general practice 1998-2003: longitudinal observational study

Substantial improvements were seen in quality of care for the three conditions studied between 1998 and 2003, a time of systematic quality improvement initiatives in the NHS.

Quality of ambulatory care for women and men in the Veterans Affairs Health Care System.

In this large national health care system that predominantly serves men, the quality of ambulatory care is equivalent for women and men on numerous measures.

New paradigms for quality in primary care.

  • B. Starfield
  • Medicine, Political Science
    The British journal of general practice : the journal of the Royal College of General Practitioners
  • 2001
Current approaches to assessing quality of care are based on models developed a half-century ago, but as in all forms of human endeavour, science and society change over time, providing primary care with new challenges.

Brief report: Quality of ambulatory care for women and men in the veterans affairs health care system

In this large national health care system that predominantly serves men, the quality of ambulatory care is equivalent for women and men on numerous measures.

Improving the quality of care through clinical governance

The UK government has set a challenging agenda for monitoring and improving the quality of health care based on a series of national standards and guidelines, a strategy for quality improvement termed “clinical governance,” and a framework for monitoring thequality of care in and performance of NHS organisations.

Effects of financial incentives on medical practice: results from a systematic review of the literature and methodological issues.

All financial incentives that had been proposed, described, or used regardless of their initial objective were identified and, when possible, assessed to assess the results of these incentives on costs, process or outcomes of care.