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Study finds wide variations in quality of primary care

15 August 2008

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The primary care provided by both NHS and private providers to many people aged over 50 fails to meet basic standards – especially for the old and frail, research has claimed.

Quality shortfalls were found in areas including osteoarthritis, incontinence and osteoporosis, according to a research paper published in the British Medical Journal.

The team from the University of East Anglia also found that doctors paid particular attention to conditions where assessments earned them extra money, including heart disease, diabetes and high-blood pressure.

Scores on the quality of care ranged from 83% for heart disease to 29% for osteoarthritis. Overall, only 62% of the care recommended for people aged 50 and over is actually received in England, the research found.

The study, which involved 8,688 people, examined 13 different health conditions including heart disease, diabetes, stroke, depression and osteoarthritis.

The researchers found that substantially more care was provided for general medical conditions (74%) than for geriatric conditions (57%), including falls, osteoarthritis, urinary incontinence, cataract problems, hearing problems and osteoporosis.

Conditions that come under the Quality and Outcomes Framework (QOF) – which incentivises GPs – received better attention.

In 75% of such cases, people got the right treatment, but only 58% of correct treatment was received by people with conditions not covered by the QOF.

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British Medical Journal