Anna Dixon: Impact of Quality and Outcomes Framework on health and health inequalities

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Dr Anna Dixon, Head of Policy at The King's Fund, discusses the findings from our report on the Quality and Outcomes Framework.

Note:

This project was funded by the National Institute for
Health Research Service Delivery and Organisation
programme (project number 08/1716/207).


The views and opinions expressed therein are those
of the authors and do not necessarily reflect those
of the NIHR SDO programme or the Department of
Health.

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Anna Dixon: Impact of Quality and Outcomes Framework on health and health inequalities

  1. 1. Impact of Quality and Outcomes Framework on health and health inequalities<br />Anna Dixon<br />Director of Policy, The King’s Fund<br />April 2011<br />
  2. 2. Objectives of the research<br />explore differences in practice performance on clinical indicators within QOF<br />identify the potential for the QOF to support the delivery of national health inequalities targets.<br />
  3. 3. Key findings<br />differences in performance by deprivation<br />impact on population health<br />practice characteristics<br />exception reporting<br />case finding.<br />
  4. 4. Small & significant differences least deprived practices in SH and non SH PCTs.<br />
  5. 5. No significant differences deprived practices in SH and non SH PCTs.<br />
  6. 6. Impact on population health<br />relationships between higher performance on QOF in specific clinical domains and the standardised rates of ACS hospital admissions<br />generally higher levels of achievement associated with lower hospital admission rates, but strength and significance vary by condition<br />how this relationship varies by area and practice deprivation<br />
  7. 7. Summary of findings<br />CHD and diabetes<br />Stroke, CHF and hypertension<br />COPD<br />Asthma<br />
  8. 8. Practice characteristics<br />Barriers to monitoring and reporting activities?<br />Relationship between well-resourced practices and high QOF achievement?<br />
  9. 9. Exception reporting across practices in England (2005/6) by income quintile<br />
  10. 10. Implications<br />align QOF to reduce health inequalities<br />reward deprived practices for meeting needs of population<br />reward population outcomes<br />link rewards to improvements not achievement of absolute thresholds<br />encourage practices to reach out to individuals<br />consider limiting practices’ ability to exempt patients who do not attend.<br />

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