| Title: |
Investigating the relationship between quality of primary care and premature mortality in England: a spatial whole-population study |
| Authors: |
Kontopantelis, Evangelos; Springate, David; Ashworth, Mark; Webb, Roger T; Buchan, Iain; Doran, Tim |
| Source: |
Kontopantelis, E, Springate, D, Ashworth, M, Webb, R T, Buchan, I & Doran, T 2015, 'Investigating the relationship between quality of primary care and premature mortality in England: a spatial whole-population study', B M J , vol. 350, h904. https://doi.org/10.1136/bmj.h904 |
| Publication Year: |
2015 |
| Collection: |
The University of Manchester: Research Explorer - Publications |
| Description: |
OBJECTIVES: To quantify the relationship between a national primary care pay-for-performance programme, the UK's Quality and Outcomes Framework (QOF), and all-cause and cause-specific premature mortality linked closely with conditions included in the framework. DESIGN: Longitudinal spatial study, at the level of the "lower layer super output area" (LSOA). SETTING: 32482 LSOAs (neighbourhoods of 1500 people on average), covering the whole population of England (approximately 53.5 million), from 2007 to 2012. PARTICIPANTS: 8647 English general practices participating in the QOF for at least one year of the study period, including over 99% of patients registered with primary care. INTERVENTION: National pay-for-performance programme incentivising performance on over 100 quality-of-care indicators. MAIN OUTCOME MEASURES: All-cause and cause-specific mortality rates for six chronic conditions: diabetes, heart failure, hypertension, ischaemic heart disease, stroke, and chronic kidney disease. We used multiple linear regressions to investigate the relationship between spatially estimated recorded quality of care and mortality. RESULTS: All-cause and cause-specific mortality rates declined over the study period. Higher mortality was associated with greater area deprivation, urban location, and higher proportion of a non-white population. In general, there was no significant relationship between practice performance on quality indicators included in the QOF and all-cause or cause-specific mortality rates in the practice locality. CONCLUSIONS: Higher reported achievement of activities incentivised under a major, nationwide pay-for-performance programme did not seem to result in reduced incidence of premature death in the population. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| ISSN: |
1756-1833 |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/25733592; info:eu-repo/semantics/altIdentifier/pissn/1756-1833; info:eu-repo/semantics/altIdentifier/eissn/1756-1833 |
| DOI: |
10.1136/bmj.h904 |
| Availability: |
https://research.manchester.ac.uk/en/publications/27d8bc93-41c7-462a-a00b-93088aeab700; https://doi.org/10.1136/bmj.h904; http://www.bmj.com/content/350/bmj.h904 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.3C8F753F |
| Database: |
BASE |