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The use of financial incentives to help improve health outcomes: is the quality and outcomes framework fit for purpose? A systematic review

Langdown, Carwyn, Peckham, Stephen (2013) The use of financial incentives to help improve health outcomes: is the quality and outcomes framework fit for purpose? A systematic review. Journal of Public Health, 36 (2). pp. 251-258. ISSN 1741-3842. (doi:10.1093/pubmed/fdt077) (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided)

The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided. (Contact us about this Publication)
Official URL
http://dx.doi.org/10.1093/pubmed/fdt077

Abstract

Background The quality and outcomes framework (QOF) is one of the world's largest pay-for-performance schemes, rewarding general practitioners for the quality of care they provide. This review examines the evidence on the efficacy of the scheme for improving health outcomes, its impact on non-incentivized activities and the robustness of the clinical targets adopted in the scheme. Methods The review was conducted using six electronic databases, six sources of grey literature and bibliography searches from relevant publications. Studies were identified using a comprehensive search strategy based on MeSH terms and keyword searches. A total of 21 543 references were identified of which 32 met the eligibility criteria with 11 studies selected for the review. Results Findings provide strong evidence that the QOF initially improved health outcomes for a limited number of conditions but subsequently fell to the pre-existing trend. There was limited impact on non-incentivized activities with adverse effects for some sub-population groups. Conclusion The QOF has limited impact on improving health outcomes due to its focus on process-based indicators and the indicators' ceiling thresholds. Further research is required to strengthen the quality of evidence available on the QOF's impact on population health to ensure that the incentive scheme is both clinically and cost-effective.

Item Type: Article
DOI/Identification number: 10.1093/pubmed/fdt077
Additional information: Published online Aug 8 2013.
Uncontrolled keywords: indicators; primary care; QOF
Subjects: R Medicine > RA Public aspects of medicine
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Tony Rees
Date Deposited: 03 Sep 2013 13:48 UTC
Last Modified: 29 May 2019 11:00 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/35071 (The current URI for this page, for reference purposes)
Peckham, Stephen: https://orcid.org/0000-0002-7002-2614
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