Research says QoF can reduce inequalities

The Quality and Outcomes Framework (QoF) has helped to reduce inequalities between rich and poor areas according to a study published this week.

Researchers from Manchester University’s National Primary Care Research and Development Centre divided 7637 GP practices in England into five groups based on their level of deprivation and monitored their performance on 48 clinical indictors in the QoF over three years.

They found that, although GP practices in the more affluent areas continued to score more highly than those in more deprived areas the gap in achievement between the groups narrowed from 4.8% to 0.8%. By the last year of the study (2006/7) practices in the most deprived areas were reporting an average achievement of 90.8% against 91.2% in the most affluent area.

The study, published online by the Lancet, also found that the worse a practice had performed in the past, the greater its improvement in achievement over the three years.

The authors concluded: “Our study has shown that variation in the quality of care related to deprivation was reduced during the first three years of the financial incentive scheme.”

They said that 60% of the gap in life expectancy between the group with the greatest material deprivation and poorest health in England and the rest of the country is due to diseases targeted in the QoF, particularly coronary heart disease, cancer and chronic obstructive pulmonary disease.

They added: “The use of financial incentives seems to have the potential to make a substantial contribution to the reduction of health inequalities.”

Link

The Lancet