Workload impact of the Quality and Outcomes Framework for patients with diabetes: an interrupted time series in general practice.
Adult
Burnout, Professional
/ epidemiology
Diabetes Mellitus
/ epidemiology
England
/ epidemiology
Female
General Practice
General Practitioners
/ psychology
Health Services Research
Humans
Interrupted Time Series Analysis
Male
Middle Aged
Practice Patterns, Physicians'
/ statistics & numerical data
Referral and Consultation
/ statistics & numerical data
Workload
/ psychology
diabetes mellitus
incentives
primary care
workload
Journal
The British journal of general practice : the journal of the Royal College of General Practitioners
ISSN: 1478-5242
Titre abrégé: Br J Gen Pract
Pays: England
ID NLM: 9005323
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
received:
16
01
2019
accepted:
13
03
2019
pubmed:
17
7
2019
medline:
7
2
2020
entrez:
17
7
2019
Statut:
ppublish
Résumé
There are substantial concerns about GP workload. The Quality and Outcomes Framework (QOF) has been perceived by both professionals and patients as bureaucratic, but the full impact of the QOF on GP workload is not well known. To assess the impact of the QOF on GP consultation rates for patients with diabetes mellitus. This study used interrupted time series of 13 248 745 general practice consultations for 37 065 patients with diabetes mellitus in England. Clinical Practice Research Datalink general practice data were used from 2000/2001 to 2014/2015, with introduction of the QOF (1 April 2004) as the intervention, and mean annual GP consultation rates as the primary outcome. Mean annual GP clinical consultation rates were 8.10 per patient in 2000/2001, 6.91 in 2004/2005, and 7.09 in 2014/2015. Introduction of the QOF was associated with an annual change in the trend of GP clinical consultation rates of 0.46 (95% confidence interval [CI] = 0.23 to 0.69, Introduction of the QOF was associated with a modest increase in clinical GP consultation rates and substantial increase in other encounters for patients with diabetes independent of changes in diabetes prevalence. National prevalence of diabetes increased by 90.7% from 2004/2005 to 2014/2015, which, combined with this study's findings, means GPs would have provided nearly double the number of consultations for patients with diabetes over this timescale.
Sections du résumé
BACKGROUND
BACKGROUND
There are substantial concerns about GP workload. The Quality and Outcomes Framework (QOF) has been perceived by both professionals and patients as bureaucratic, but the full impact of the QOF on GP workload is not well known.
AIM
OBJECTIVE
To assess the impact of the QOF on GP consultation rates for patients with diabetes mellitus.
DESIGN AND SETTING
METHODS
This study used interrupted time series of 13 248 745 general practice consultations for 37 065 patients with diabetes mellitus in England.
METHOD
METHODS
Clinical Practice Research Datalink general practice data were used from 2000/2001 to 2014/2015, with introduction of the QOF (1 April 2004) as the intervention, and mean annual GP consultation rates as the primary outcome.
RESULTS
RESULTS
Mean annual GP clinical consultation rates were 8.10 per patient in 2000/2001, 6.91 in 2004/2005, and 7.09 in 2014/2015. Introduction of the QOF was associated with an annual change in the trend of GP clinical consultation rates of 0.46 (95% confidence interval [CI] = 0.23 to 0.69,
CONCLUSION
CONCLUSIONS
Introduction of the QOF was associated with a modest increase in clinical GP consultation rates and substantial increase in other encounters for patients with diabetes independent of changes in diabetes prevalence. National prevalence of diabetes increased by 90.7% from 2004/2005 to 2014/2015, which, combined with this study's findings, means GPs would have provided nearly double the number of consultations for patients with diabetes over this timescale.
Identifiants
pubmed: 31308001
pii: bjgp19X704645
doi: 10.3399/bjgp19X704645
pmc: PMC6650130
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e570-e577Informations de copyright
© British Journal of General Practice 2019.
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