wow-inequalities/02-data/intermediate/wos_sample/d0b1157d75f0f5b1889a5710d2e855ce-glidewell-liz-and-w/info.yaml

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2023-09-28 14:46:10 +00:00
abstract: 'Background: Socioeconomic deprivation is associated with inequalities in
health care and outcomes. Despite concerns that the Quality and Outcomes
Framework pay-for-performance scheme in the UK would exacerbate
inequalities in primary care delivery, gaps closed over time. Local
schemes were promoted as a means of improving clinical engagement by
addressing local health priorities. We evaluated equity in achievement
of target indicators and practice income for one local scheme.
Methods: We undertook a longitudinal survey over four years of routinely
recorded clinical data for all 83 primary care practices. Sixteen
indicators were developed that covered five local clinical and public
health priorities: weight management; alcohol consumption; learning
disabilities; osteoporosis; and chlamydia screening. Clinical indicators
were logit transformed from a percentage achievement scale and modelled
allowing for clustering of repeated measures within practices. This
enabled our study of target achievements over time with respect to
deprivation. Practice income was also explored.
Results: Higher practice deprivation was associated with poorer
performance for five indicators: alcohol use registration (OR 0.97; 95
\% confidence interval 0.96,0.99); recorded chlamydia test result (OR
0.97; 0.94,0.99); osteoporosis registration (OR 0.98; 0.97,0.99);
registration of repeat prednisolone prescription (OR 0.98; 0.96,0.99);
and prednisolone registration with record of dual energy X-ray
absorptiometry (DEXA) scan/referral (OR 0.92; 0.86,0.97); practices in
deprived areas performed better for one indicator (registration of
osteoporotic fragility fracture (OR 1.26; 1.04,1.51). The
deprivation-achievement gap widened for one indicator (registered
females aged 65-74 with a fracture referred for a DEXA scan; OR 0.97;
0.95,0.99). Two other indicators indicated a similar trend over two
years before being withdrawn (registration of fragility fracture and
over-75 s with a fragility fracture assessed and treated for
osteoporosis risk). For one indicator the deprivation-achievement gap
reduced over time (repeat prednisolone prescription (OR 1.01;
1.01,1.01). Larger practices and those serving more affluent areas
earned more income per patient than smaller practices and those serving
more deprived areas (t = -3.99; p = 0.0001).
Conclusions: Any gaps in achievement between practices were modest but
mostly sustained or widened over the duration of the scheme. Given that
financial rewards may not reflect the amount of work undertaken by
practices serving more deprived patients, future pay-for-performance
schemes also need to address fairness of rewards in relation to
workload.'
affiliation: 'Hackett, JEC (Corresponding Author), Univ Leeds, Leeds Inst Hlth Sci,
Charles Thackrah Bldg,101 Clarendon Rd, Leeds, W Yorkshire, England.
Glidewell, Liz; West, Robert; Hackett, Julia E. C.; Foy, Robbie, Univ Leeds, Leeds
Inst Hlth Sci, Leeds, W Yorkshire, England.
Carder, Paul, Yorkshire \& Humber Commissioning Support Unit, Bradford, W Yorkshire,
England.
Doran, Tim, Univ York, Dept Hlth Sci, York YO10 5DD, N Yorkshire, England.'
article-number: '61'
author: Glidewell, Liz and West, Robert and Hackett, Julia E. C. and Carder, Paul
and Doran, Tim and Foy, Robbie
author-email: j.e.hackett@leeds.ac.uk
author_list:
- family: Glidewell
given: Liz
- family: West
given: Robert
- family: Hackett
given: Julia E. C.
- family: Carder
given: Paul
- family: Doran
given: Tim
- family: Foy
given: Robbie
da: '2023-09-28'
doi: 10.1186/s12875-015-0279-9
eissn: 1471-2296
files: []
journal: BMC FAMILY PRACTICE
keywords: Primary health care; Social deprivation; Pay-for-performance
keywords-plus: 'GENERAL-PRACTICE; OUTCOMES FRAMEWORK; QUALITY; PERFORMANCE; PAY; UK;
INDICATORS; IMPACT'
language: English
month: MAY 14
number-of-cited-references: '31'
orcid-numbers: 'Glidewell, Liz/0000-0003-2519-2654
Glidewell, Liz/0000-0003-2519-2654
Foy, Robbie/0000-0003-0605-7713
carder, paul/0000-0002-7940-6016'
papis_id: 774ff2e0c72b936f0c70b9eb700f99fc
ref: Glidewell2015doeslocal
researcherid-numbers: 'Glidewell, Liz/N-8832-2019
Glidewell, Liz/G-7338-2011
'
times-cited: '5'
title: Does a local financial incentive scheme reduce inequalities in the delivery
of clinical care in a socially deprived community? A longitudinal data analysis
2023-10-01 08:15:07 +00:00
type: article
2023-09-28 14:46:10 +00:00
unique-id: WOS:000354834500002
usage-count-last-180-days: '0'
usage-count-since-2013: '10'
volume: '16'
web-of-science-categories: Primary Health Care; Medicine, General \& Internal
year: '2015'