Using the UK primary care Quality and Outcomes Framework to audit health care equity: preliminary data on diabetes management

Sigfrid, L.A., Turner, C., Crook, D. and Ray, S. (2006) Using the UK primary care Quality and Outcomes Framework to audit health care equity: preliminary data on diabetes management. Journal of Public Health, 28 (3). pp. 221-225. ISSN 1741-3850

[img] PDF
Restricted to SRO admin only

Download (95kB)

Abstract

Background The incentivization of UK primary care through the Quality and Outcomes Framework (QOF) has released an unprecedented supply of data that in theory could aid health equity audit and reduce health inequalities. The current system allows for ‘exception reporting’ whereby patients can be excluded from calculation of payment for reasons such as failure to attend review. We speculated that such exclusions could be linked to socioeconomic deprivation. Methods We assessed ‘exception reporting’ rates for 15 diabetes indicators using 2004/05 QOF data for 49 general practitioner (GP) practices in Brighton and Hove and related it to a deprivation ranking for each practice. Results The standardized diabetes prevalence was 26% higher (P < 0.001) in the highest compared to the lowest quintile of deprivation. Correlations between ‘exception reporting’ and deprivation were seen for 10 of the 15 diabetes indicators (r = 0.20–0.41, P < 0.05). Practices with a more deprived patient population were more likely to report ‘exceptions’ for QOF indicators, although there was no such relationship with the achievement of QOF targets. Conclusions Strategies to reduce health inequalities need to take into account that high levels of exception reporting, particularly in practices with deprived populations, may be disguising unmet need in those populations.

Item Type: Article
Keywords: deprivation, diabetes, equity audit, exception reporting, inequality, Quality, Outcomes Framework
Schools and Departments: Brighton and Sussex Medical School > Primary Care and Public Health
Depositing User: Jane Harle
Date Deposited: 21 Oct 2008
Last Modified: 13 Mar 2017 12:00
URI: http://sro.sussex.ac.uk/id/eprint/2025
Google Scholar:44 Citations

View download statistics for this item

📧 Request an update