Effect of a UK pay-for-performance program on ethnic disparities in diabetes outcomes: interrupted time series analysis.

Annals of Family Medicine
Riyadh AlshamsanChristopher Millett

Abstract

We wanted to examine the long-term effects of the Quality and Outcomes Framework (QOF), a major pay-for-performance program in the United Kingdom, on ethnic disparities in diabetes outcomes. We undertook an interrupted time series analysis of electronic medical record data of diabetes patients registered with 29 family practices in South West London, United Kingdom. Main outcome measures were mean hemoglobin A(1c) (HbA(1c)), total cholesterol, and blood pressure. The introduction of QOF was associated with initial accelerated improvements in systolic blood pressure in white and black patients, but these improvements were sustained only in black patients (annual decrease: -1.68 mm Hg; 95% CI, -2.41 to -0.95 mm Hg). Initial improvements in diastolic blood pressure in white patients (-1.01 mm Hg; 95% CI, -1.79 to -0.24 mm Hg) and in cholesterol in white (-0.13 mmol/L; 95% CI, -0.21 to -0.05 mmol/L) and black (-0.10 mmol/L; 95% CI, -0.20 to -0.01 mmol/L) patients were not sustained in the post-QOF period. There was no beneficial impact of QOF on HbA(1c) in any ethnic group. Existing disparities in risk factor control remained largely intact (for example; mean HbA(1c): white 7.5%, black 7.8%, south Asian 7.8%; P <.05) at the end of ...Continue Reading

References

Aug 14, 2002·Journal of Clinical Pharmacy and Therapeutics·A K WagnerD Ross-Degnan
Oct 19, 2007·Medical Care Research and Review : MCRR·Alyna T ChienLawrence P Casalino
May 29, 2009·BMJ : British Medical Journal·Melanie CalvertNick Freemantle
Jul 25, 2009·The New England Journal of Medicine·Stephen M CampbellMartin Roland
May 13, 2010·Health Services Research·Karen HoCarolyn M Clancy
Aug 25, 2010·BMC Health Services Research·Pieter Van HerckWalter Sermeus
Jan 26, 2011·BMJ : British Medical Journal·Christopher MillettJosip Car

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Citations

Oct 10, 2013·Diabetic Medicine : a Journal of the British Diabetic Association·C J HillD G Fogarty
Aug 26, 2015·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Audrey Michel-Lepage, Bruno Ventelou
Jun 3, 2015·Israel Journal of Health Policy Research·Shlomo VinkerArnon D Cohen
Jul 1, 2014·Atencion primaria·Beatriz Pascual de la PisaUNKNOWN investigadores del estudio DESIDIAB 1
Dec 3, 2014·Canadian Journal of Diabetes·Lesley P Latham, Emily Gard Marshall
May 29, 2015·Ciência & saúde coletiva·Jorge Otávio Maia Barreto
Nov 7, 2016·Medical Care Research and Review : MCRR·Anthony ScottJongsay Yong
Jan 9, 2016·Medical Care Research and Review : MCRR·Adam A Markovitz, Andrew M Ryan
Mar 3, 2017·The Cochrane Database of Systematic Reviews·Beibei YuanLiying Jia
Sep 28, 2017·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Lindsay Jl ForbesStephen Peckham
Oct 11, 2017·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Rishi MandaviaElias Mossialos
Jul 6, 2018·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·F P VlaanderenP P T Jeurissen
Jan 21, 2021·The Cochrane Database of Systematic Reviews·Liying JiaLu Zhang

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