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QOF does not help promote healthier lifestyles, claims study

12 August 2008

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Incentivising primary care through means such as the Quality and Outcomes Framework (QOF) does not improve the quality of life for patients with coronary heart disease (CHD), research suggests.

Researchers from the Department of General Practice and Primary Care at Dunluce Health Centre in Belfast assessed 903 patients from 48 general practices.

Sixteen of these were in Northern Ireland, which is part of the UK NHS and is therefore rewarded through the QOF. The other 32 practices were in the Republic of Ireland, with no performance-related pay.

Analysis showed that blood pressure and cholesterol levels were better controlled among patients in the Northern Ireland practices. And more of these patients had had these levels checked in the previous year.

Republic of Ireland patients also made more outpatient visits, and had more hospital admissions than their Northern Ireland counterparts.

However, patients in Northern Ireland ate a less healthy diet and took significantly less exercise than patients in the Republic, who scored higher on validated measures of physical and emotional wellbeing.

The researchers point out that healthcare systems are complex, as are the results of strategies designed to improve health.

They argue that the evidence suggests the quality of care was already improving in primary care before the new GP contract, with its inclusion of incentives, was introduced.