Pay for performance improves blood pressure monitoring
Pay for performance improves blood pressure monitoring, experts claim
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Wednesday, 29, Oct 2008 08:00
Pay for performance has substantially improved blood pressure monitoring and control in England, research shows.
In a report published on BMJ Online today, experts also argue the difference in monitoring levels between the most and least deprived areas has "all but disappeared".
Previous studies have found that successful blood pressure control could prevent 43,000 strokes and 83,000 cases of heart disease in the UK each year, but that these statistics were less likely to be achieved in socially deprived areas.
The Quality of Outcomes Framework (QOF) was first introduced in 2004 to improve standards of primary care by linking financial incentives to 135 performance indicators for all general practitioners in the UK.
These included the target of annual blood pressure monitoring of all primary care patients older than 45 years and meeting blood pressure control targets in patients with chronic diseases.
For the report, researchers from Kings College London looked at data from the first three years of the QOF's implementation.
They examined the effect of social deprivation on the achievement of blood pressure targets between general practices in deprived and less deprived communities in England.
The authors found that blood pressure recording increased from 82.3 per cent (52.8 million) of adults in 2005 to 88.3 per cent (53.2 million) in 2007, and that the gap between median blood pressure recording levels narrowed from 1.7 per cent to 0.2 per cent between practices in the most deprived and least deprived areas.
Today's report shows that performance indicators linked to financial incentives result in "improved achievement of targets, which at the same time narrows health inequalities", the authors conclude.
"Perhaps the greatest contribution that the QOF has made to changing practice will therefore be the largely unintended consequence of generating more equitable healthcare," said Professor Helen Lester from the National Primary Care Research and Development Centre.