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Do quality improvements in primary care reduce secondary care costs? / Stephen Martin / London [United Kingdom] : The Health Foundation (2010)  

Do quality improvements in primary care reduce secondary care costs? [printed text] / Stephen Martin, Author ; Peter C. Smith, Author ; Mark Dusheiko, Author ; Hugh Gravelle, Author ; Nigel Rice, Author . - London [United Kingdom] : The Health Foundation, 2010 . - X, 46 p. : ill. ; A4. € 0,00 Languages : English (eng) Descriptors: Indexation Cost-effectiveness analysis ; Great Britain ; Health Care Costs ; Outcome Assessment (Health Care) ; Primary Health Care ; Quality improvement ; Quality of Health Care Classification W 84.4 Quality of health care (General) Abstract: The introduction in 2004 of the Quality and Outcomes Framework (QOF) in UK general practice represents one of the most ambitious efforts to measure and incentivise quality improvements in primary care. This report takes advantage of a large database of over 50 million English citizens to determine whether the levels of QOF attainment in general practices have led to improvements in two major outcomes: mortality and the costs of hospital inpatient and outpatient use. Our findings are that primary care performance improvements are associated with some modest but measurable improvements in subsequent outcomes and costs. Contents note: CHAPTER 1 Introduction 1 -- 1.1 GP contracts 1 -- 1.2 Quality indicators 1 -- 1.3 Practice QOF scores and hospital admission rates 2 -- 1.4 Drawing on a new dataset 2 -- 1.5 Report structure 3 -- CHAPTER 2 Theoretical background 4 -- 2.1 Effectiveness or cost-effectiveness? 4 -- 2.2 Scope of this study 4 -- 2.3 A mathematical model 4 -- CHAPTER 3 The Quality and Outcomes Framework (QOF) 6 -- 3.1 QOF 2004/05 and 2005/06 6 -- 3.2 QOF 2006/07 and 2007/08 11 -- CHAPTER 4 The dataset and the development of a basic model of hospital costs 16 -- 4.1 A model for patient expenditure 16 -- 4.2 The estimation sample 18 -- 4.3 The estimation method 18 -- 4.4 Derivation of a parsimonious model for hospital expenditure 18 -- CHAPTER 5 Variants of the base model, and further analysis 23 -- 5.1 Updating the QOF stroke achievement score 23 -- 5.2 Deriving a new parsimonious model with a binary (patient died) dependent variable 26 -- 5.3 Deriving parsimonious models for individual disease areas 28 -- 5.4 Panel data estimation 33 -- CHAPTER 6 Conclusions 40 -- 6.1 Base model findings 40 -- 6.2 Panel data model findings 40 -- 6.3 Scope for future research 41 -- 6.4 QOF – material but limited gains? 41 -- ENDNOTES 42 -- REFERENCES 45 -- APPENDIX: Grounds for exception reporting patients 46 Link for e-copy: http://www.health.org.uk/media_manager/public/75/QOFnew.pdf Format of e-copy: PDF [Open Access] Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2458

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Barcode	Call number	Media type	Location	Section	Status
10273-02201	W 84. 4 / MAR	Report	KCE	Library (10.124)	Available