Population Intermediate Outcomes of Diabetes Under Pay-for-Performance Incentives in England From 2004 to 2008

Vaghela, Parth; Ashworth, Mark; Schofield, Peter; Gulliford, Martin

doi:10.2337/dc08-1999

Cited by 56 publications

(54 citation statements)

References 8 publications

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“…However, the American Behavioral Risk Factor Surveillance System (BRFSS) study (70.3% of patients with systolic BP <140 mmHg) (16) and the British pay-for-performance study (80.2% with BP ≤145/85 mmHg) (20) achieved better control values than those observed in our study.…”

Section: Discussioncontrasting

confidence: 82%

Control of Glycemia and Cardiovascular Risk Factors in Patients With Type 2 Diabetes in Primary Care in Catalonia (Spain)

Vinagre

Mata-Cases²,

Hermosilla³

et al. 2012

Diabetes Care

211

104

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OBJECTIVEThe objective of this study was to analyze the clinical characteristics and levels of glycemic and cardiovascular risk factor control in patients with type 2 diabetes that are in primary health care centers in Catalonia (Spain).RESEARCH DESIGN AND METHODSThis was a cross-sectional study of a total population of 3,755,038 individuals aged 31–90 years at the end of 2009. Clinical data were obtained retrospectively from electronic clinical records.RESULTSA total of 286,791 patients with type 2 diabetes were identified (7.6%). Fifty-four percent were men, mean (SD) age was 68.2 (11.4) years, and mean duration of disease was 6.5 (5.1) years. The mean (SD) A1C value was 7.15 (1.5)%, and 56% of the patients had A1C values ≤7%. The mean (SD) blood pressure (BP) values were 137.2 (13.8)/76.4 (8.3) mmHg, mean total cholesterol concentration was 192 (38.6) mg/dL, mean HDL cholesterol concentration was 49.3 (13.2) mg/dL, mean LDL cholesterol (LDL-C) concentration was 112.5 (32.4) mg/dL, and mean BMI was 29.6 (5) kg/m2. Thirty-one percent of the patients had BP values ≤130/80 mmHg, 37.9% had LDL-C values ≤100 mg/dL, and 45.4% had BMI values ≤30 kg/m2. Twenty-two percent were managed exclusively with lifestyle changes. Regarding medicated diabetic patients, 46.9, 22.9, and 2.8% were prescribed one, two, or three antidiabetic drugs, respectively, and 23.4% received insulin therapy.CONCLUSIONSThe results from this study indicate a similar or improved control of glycemia, lipids, and BP in patients with type 2 diabetes when compared with previous studies performed in Spain and elsewhere.

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Section: Discussioncontrasting

confidence: 82%

Control of Glycemia and Cardiovascular Risk Factors in Patients With Type 2 Diabetes in Primary Care in Catalonia (Spain)

Vinagre

Mata-Cases²,

Hermosilla³

et al. 2012

Diabetes Care

211

104

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“…[9][10][11] It is not known, however, how much of this improvement is attributable to the incentive scheme and how much to underlying trends in quality improvement. There is also little evidence on the impact of the incentives on activities lying outside the incentive scheme.…”

Section: Introductionmentioning

confidence: 99%

Effect of financial incentives on incentivised and non-incentivised clinical activities: longitudinal analysis of data from the UK Quality and Outcomes Framework

Doran

Kontopantelis

Valderas

et al. 2011

BMJ

227

216

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Objective To investigate whether the incentive scheme for UK general practitioners led them to neglect activities not included in the scheme.Design Longitudinal analysis of achievement rates for 42 activities (23 included in incentive scheme, 19 not included) selected from 428 identified indicators of quality of care.Setting 148 general practices in England (653 500 patients). Results Achievement rates improved for most indicators in the pre-incentive period. There were significant increases in the rate of improvement in the first year of the incentive scheme (2004-5) for 22 of the 23 incentivised indicators. Achievement for these indicators reached a plateau after 2004-5, but quality of care in 2006-7 remained higher than that predicted by pre-incentive trends for 14 incentivised indicators. There was no overall effect on the rate of improvement for non-incentivised indicators in the first year of the scheme, but by 2006-7 achievement rates were significantly below those predicted by pre-incentive trends. Main outcome measuresConclusions There were substantial improvements in quality for all indicators between 2001 and 2007. Improvements associated with financial incentives seem to have been achieved at the expense of small detrimental effects on aspects of care that were not incentivised.

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“…We experienced difficulty with recruitment because we targeted patients with suboptimal glycemic control in the context of an incentive scheme for physicians to improve care in this group. 29 Identification of potential study participants using a wide scale strategy rather than contacting individual…”

Section: Discussionmentioning

confidence: 99%

Stepwise Self-Titration of Oral Glucose-Lowering Medication Using a Mobile Telephone-Based Telehealth Platform in Type 2 Diabetes: A Feasibility Trial in Primary Care

Nagrebetsky

Larsen

Craven

et al. 2013

J Diabetes Sci Technol

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Population Intermediate Outcomes of Diabetes Under Pay-for-Performance Incentives in England From 2004 to 2008

Cited by 56 publications

References 8 publications

Control of Glycemia and Cardiovascular Risk Factors in Patients With Type 2 Diabetes in Primary Care in Catalonia (Spain)

Control of Glycemia and Cardiovascular Risk Factors in Patients With Type 2 Diabetes in Primary Care in Catalonia (Spain)

Effect of financial incentives on incentivised and non-incentivised clinical activities: longitudinal analysis of data from the UK Quality and Outcomes Framework

Stepwise Self-Titration of Oral Glucose-Lowering Medication Using a Mobile Telephone-Based Telehealth Platform in Type 2 Diabetes: A Feasibility Trial in Primary Care

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