Special Article
Pay-for-Performance Programs in Family Practices in the United Kingdom
N Engl J Med 2006; 355:375-384July 27, 2006
- Abstract
Background
In 2004, after a series of national initiatives associated with marked improvements in the quality of care, the National Health Service of the United Kingdom introduced a pay-for-performance contract for family practitioners. This contract increases existing income according to performance with respect to 146 quality indicators covering clinical care for 10 chronic diseases, organization of care, and patient experience.
Methods
We analyzed data extracted automatically from clinical computing systems for 8105 family practices in England in the first year of the pay-for-performance program (April 2004 through March 2005), data from the U.K. Census, and data on characteristics of individual family practices. We examined the proportion of patients deemed eligible for a clinical quality indicator for whom the indicator was met (reported achievement) and the proportion of the total number of patients with a medical condition for whom a quality indicator was met (population achievement), and we used multiple regression analysis to determine the extent to which practices achieved high scores by classifying patients as ineligible for quality indicators (exception reporting).
Results
The median reported achievement in the first year of the new contract was 83.4 percent (interquartile range, 78.2 to 87.0 percent). Sociodemographic characteristics of the patients (age and socioeconomic features) and practices (size of practice, number of patients per practitioner, age of practitioner, and whether the practitioner was medically educated in the United Kingdom) had moderate but significant effects on performance. Exception reporting by practices was not extensive (median rate, 6 percent), but it was the strongest predictor of achievement: a 1 percent increase in the rate of exception reporting was associated with a 0.31 percent increase in reported achievement. Exception reporting was high in a small number of practices: 1 percent of practices excluded more than 15 percent of patients.
Conclusions
English family practices attained high levels of achievement in the first year of the new pay-for-performance contract. A small number of practices appear to have achieved high scores by excluding large numbers of patients by exception reporting. More research is needed to determine whether these practices are excluding patients for sound clinical reasons or in order to increase income.
Media in This Article
Table 1
Examples of Quality Indicators from the 10 Clinical Domains.Table 2
Reasons That Family Practitioners Can Record in Order to Exclude (Exception-Report) Patients from the Pay-for-Performance Scheme.Article Activity
- Article
There is widespread variation in the quality of care in all major health care systems.1,2 In the United Kingdom, where there is a single health care system (the National Health Service), the government has introduced several quality-improvement initiatives since 1998, including national guidelines, a system of “clinical governance” giving clinicians and managers responsibility for delivering high-quality care, and a national inspection system.3,4 There is evidence that these initiatives have substantially improved primary care performance.5-7
In 2004, the National Health Service committed £1.8 billion ($3.2 billion) in additional funding over a period of three years for a new pay-for-performance program for family practitioners (the sole type of primary care physician in the United Kingdom).8 This program was intended to increase family practitioners' income by up to 25 percent, depending on their performance with respect to 146 quality indicators relating to clinical care for 10 chronic diseases, organization of care, and patient experience.9 For the clinical indicators, practices claim points that generate payments according to the proportion of patients for whom they achieve each target (for examples, see Table 1Table 1
Examples of Quality Indicators from the 10 Clinical Domains.; for the complete list, see Supplementary Appendix 1, available with the full text of this article at www.nejm.org). Points are awarded on a sliding scale within the payment range. For example, for asthma indicator number 6, practices gain points for clinically reviewing at least 25 percent of patients with asthma in the previous 15 months. The maximum of 20 points is gained if at least 70 percent of patients with asthma are reviewed. For 2004–2005, payment was limited to £76 ($133) per point, adjusted for the relative prevalence of the disease (payment is multiplied by the square root of the prevalence of the disease among the patients served by the practice and divided by the square root of the mean national prevalence of the disease). A maximum of 1050 points was available, which was equivalent to an average of £79,800 ($139,400). From 2005–2006 onward, practices have been earning £125 ($218) per point. The payments are in addition to the practices' core funding, which is based on the number of patients, adjusted for characteristics of the patients and the area.Financial incentives affect physician behavior.10 A narrow national pay-for-performance program introduced in 1991 in the United Kingdom was associated with large improvements in rates of immunization and cervical cytologic examinations.11,12 A more ambitious local scheme covering a range of diseases, with financial incentives aligned with family practitioners' professional values, was also successful.13 In preparation for the 2004 program, U.K. family practitioners employed more nurses and administrative staff, established chronic-disease clinics,14 and increased the use of electronic medical records.
Evidence-based quality indicators should not be applied unthinkingly, since patients have coexisting conditions that affect their optimal care.15 It is inappropriate, for example, to strive to control the cholesterol level of someone terminally ill with cancer. Consequently, the new U.K. pay-for-performance contract allows family practitioners to exclude patients from eligibility for specific indicators in the performance calculations.16 The reasons for these exclusions (termed “exception reports”) are summarized in Table 2Table 2
Reasons That Family Practitioners Can Record in Order to Exclude (Exception-Report) Patients from the Pay-for-Performance Scheme.. However, exception reporting also provides an opportunity for family practitioners to increase their income by inappropriately excluding patients for whom they have missed the targets (a practice known as gaming).We report performance on clinical quality indicators for 10 chronic conditions in the first year of the new pay-for-performance program. We examine whether the socioeconomic, demographic, and health characteristics of practice populations and characteristics of the practices themselves affect the quality of clinical care provided. We also assess exception reporting according to practice and its effect on achievement of the clinical targets.
Methods
Analyses in this article are restricted to the 76 clinical quality indicators, which account for 550 of the 1050 potential points. The remaining 500 points were based on quality indicators assessing organizational quality and patient experience (not analyzed here). Details of data and methods are given in Supplementary Appendix 2, available with the full text of this article at www.nejm.org. The practices recorded the number of patients with each condition who were listed in their practice registers on February 14, 2005 (R0). For each clinical indicator (i), the practices flagged the electronic medical records of patients deemed appropriate for that indicator (the number of these patients is the denominator, Di) and patients for whom the indicator was met (the number of these patients is the numerator, Ni). These data were extracted by an automated national computer system and collated in a central database called the Quality Management and Analysis System (QMAS). Register data for each condition (R0) and summary data for each indicator (Di, Ni) were published for all practices in England in August 2005 (available at www.ic.nhs.UK./services/qof/).
Data for exception reports were not available on the QMAS database and were imputed. For example, QMAS might document that there were 100 patients (R0) in a practice's hypertension register and that the practice met the target of recording the blood pressure of 75 (Ni) of 80 (Di) patients with hypertension. The practice's reported achievement on this indicator is 94 percent (Ni/Di). We can calculate that 20 patients (100−80, i.e., R0−Di) were excluded (exception-reported) for this indicator by the practice, and that the actual level of achievement of blood-pressure recording in the whole population of patients with hypertension was 75 percent (75 of 100). The practices were paid on the basis of their reported achievement (94 percent in this example).
Imputation of exception reports was possible only for indicators that were based on all patients with the condition (30 of the 76 indicators) (see Supplementary Appendix 1). For example, imputation was possible for asthma indicator number 6 (the percentage of patients with asthma reviewed in the previous 15 months) but not for epilepsy indicator number 4 (the percentage of patients 16 years of age or older receiving drug treatment for epilepsy who were convulsion-free for the previous 12 months), because the latter indicator is based on a subgroup of patients. We therefore calculated a score that measured the overall propensity of a practice to exclude patients. A complication of the QMAS data-collection method was that although the practices reported overall disease prevalence on February 14 (R0), the numerators and denominators for individual indicators were reported six weeks later, on March 31, and the practices could continue to add patients to their disease registers during this period. Consequently, the denominator for an indicator (Di) could be greater than the reported number of patients registered for the disease (R0), and as a result the true number of patients registered on March 31 (R1) would be unknown. In such cases, we estimated R1 by using the largest available denominator, Di, for the indicators for that disease.
We report practice outcomes with respect to clinical indicators in three ways: the reported achievement is the proportion of patients declared appropriate for an indicator for whom the practice met the indicator (Ni÷Di); the population achievement is the number of patients for whom the indicator was met as a proportion of the estimated number of patients with the condition (Ni÷R1); and the rate of exception reporting is the estimated number of patients who were exception-reported (excluded) for the indicator as a proportion of the estimated number of patients with the condition [(R1–Di)÷R1].
Summary outcome scores for each condition were constructed as weighted mean scores for the score on each indicator, where the weights were the number of points available for each indicator. A global score was similarly constructed as a weighted mean across all conditions.
Information on practice characteristics was taken from the 2004 General Medical Statistics database maintained by the Department of Health. Socioeconomic characteristics were attributed to each practice with data from the 2001 Census and the Indices of Deprivation17 for the population of the electoral district where the practice was located. Although all practices took part in the new quality incentive framework, 42 percent were operating under an alternative Primary Medical Services contract with minor differences in the pay-for-performance scheme that diluted their financial incentives. However, the same clinical data were collected for all practices. We included an indicator for Primary Medical Services practices.
The QMAS database contains data from 8576 practices with 1 or more family practitioners (with a mean of 3.2 full-time equivalents) providing services for a defined population. Practices were excluded from the study if they had fewer than 1000 patients (61 practices) or if the reported register was missing (92 practices), contained no patients (272 practices), or included less than half the patients subsequently reported for individual indicators (109 practices). Our results are drawn from 8105 practices (94.5 percent; some practices had more than one of the exclusion criteria).
Linear multiple least-squares regressions with robust estimates of error variance were estimated for each outcome with the use of Stata software, version 8. The practice scores had heterogeneous variance, depending on patient numbers, and therefore analytical weights that were approximately inversely proportional to the variance at each practice were used. Each analysis used the same set of practice and population characteristics as explanatory variables. The regression for reported achievement also included the rate of exception reporting. Indicator variables (fixed effects) were included to allow for unobserved effects of policies of the Primary Care Trust where the practice was located. Outcome variables were expressed as percentages ranging from 0 to 100. All variables were divided by their standard deviations, and therefore the reported coefficients show the increase in the standard deviations of outcome variables for each increase of one standard deviation in predictor variables. Sensitivity analyses with respect to weighting scores and calculating rates of exception reporting are reported in Supplementary Appendix 2.
Ethics-committee approval was not required for this study, since it was based on publicly available data.
Results
Practice Performance under the New Financial Incentive Program
The practices scored a median of 1003 points (interquartile range, 948 to 1033), or 95.5 percent of those available, earning an average of £76,200 ($133,200) each. Of the 8105 practices, 230 (2.8 percent) scored the maximum of 1050 points. On the clinical indicators, the practices scored a median of 532 points (interquartile range, 504 to 545), or 96.7 percent of those available, with 591 practices (7.3 percent) scoring the maximum of 550.
The median reported achievement — that is, the proportion of eligible patients for whom the targets were actually achieved — was 83.4 percent overall; the reported achievement for individual diseases ranged from 80.1 percent for diabetes to 96.0 percent for hypothyroidism (Table 3Table 3
Summary Statistics for the Performance of 8105 Family Practices in England with Respect to Clinical Quality Indicators, 2004–2005.).The overall rates of exception reporting were generally low (median, 6.0 percent) but ranged widely from 0 percent to 85.8 percent (Table 3), with 91 practices (1.1 percent) excluding more than 15 percent of their patients. The median rates of exception reporting for disease domains ranged from 0.8 percent for hypothyroidism to 9.5 percent for mental health problems.
The median population achievement (the proportion of all patients with the condition for whom the target was achieved, including those who were exception-reported) was estimated at 82.9 percent overall, ranging from 72.8 percent for asthma to 95.3 percent for hypothyroidism (Table 3).
Factors Associated with Overall Performance
Characteristics of practices, patients, and local areas had significant effects on population achievement (Table 4Table 4
Regression Analyses of the Association of Area, Patient, and Practice Characteristics with Reported Achievement, Rates of Exception Reporting, and Population Achievement in Family Practices in England, 2004–2005.). Achievement was lower in practices with a high proportion of patients who were living in single-parent or low-income households or were 65 years of age or older. Achievement was also lower in larger practices and in practices with a high proportion of family practitioners who received their medical education outside the United Kingdom or were 50 years of age or older. Achievement was higher in practices with a high ratio of family practitioners to patients and lower in practices that were on the Primary Medical Services contract. However, the multiple regression model explained only 20 percent of the variation between practices, and all of these effects were small. The number of patients, for example, had the effect of reducing achievement by 0.13 percent for every additional 1000 patients on the practice list.For reported achievement (Table 4), the factor with the greatest effect was exception reporting. An increase of 1 percent in the estimated proportion of patients excluded was associated with an increase of 0.31 percent in reported achievement.
The rates of exception reporting were higher in Primary Medical Services practices and lower in practices with larger populations of elderly patients, patients with good self-rated health, and patients without any formal educational qualifications (Table 4). However, the model explained only 20 percent of the variation between practices, and the effects of individual explanatory variables were small.
Discussion
In the first year of the pay-for-performance program, English family practitioners performed extremely well with respect to the quality targets, attaining a median of 96.7 percent of the available points for clinical indicators. This greatly exceeded the 75 percent predicted when the scheme was negotiated, and consequently the cost to the taxpayers was considerably more than expected. Before the new contract was implemented, family practitioners typically earned from £70,000 to £75,000 ($122,000 to $131,000). The pay-for-performance program increased the gross income of the average family practitioner by £23,000 ($40,200), although the practitioners bore any additional nursing and administrative costs of meeting the targets. In 2005–2006, family-practitioner income will rise even more, since quality payments have been increased to £125 ($218) per point.
Exact comparisons with U.S. data on quality of care are difficult because of differences in indicators, dates of data collection, and samples.18 However, some limited comparisons are possible. For example, 91 percent of patients with diabetes had their glycated hemoglobin levels measured in 2004–2005 under the new pay-for-performance program in England. In comparison, glycated hemoglobin levels were measured in 94 percent of patients with diabetes treated by the U.S. Department of Veterans Affairs in 1999–200019 and 93 percent of such patients in 2000–2002,20 in 83 percent of patients with diabetes treated by commercial managed care groups in the United States in 2000–2002,20 in 82 percent of patients with diabetes treated by Pacific Northwest physician groups with pay-for-performance programs in 2001–2002, in 64 percent of patients with diabetes treated by California physician groups with pay-for-performance programs in 2002–2003,21 in 89 percent of Medicare patients with diabetes in 2004,22 and in 76 percent of Medicaid patients with diabetes in 2004.22 For other aspects of diabetes care, including blood lipid testing, eye examinations, microalbuminuria screening, and influenza vaccination, performance in the first year of the new contract also placed family practitioners in England on a par with their better-performing U.S. peers.
There is no baseline with which to compare performance in the first year of the U.K. program, although the quality of care was already improving before its introduction.6 The high levels of achievement might suggest that the targets were too easy to achieve.23 The scheme has been revised for 2006–2007: all minimum and some maximum payment thresholds have been raised, 30 indicators have been dropped or modified, and 18 new indicators have been introduced.24 The high achievement levels might also have resulted from misreporting by practices. To counter misreporting, Primary Care Trusts, statutory bodies responsible for the delivery of health care in local areas, inspect all local practices and undertake detailed audits of randomly selected practices and those suspected of incorrect or fraudulent returns. The results of these audits are not, however, publicly available.
Because achievement was universally high, there was little variation between practices. It was not surprising, therefore, that socioeconomic and demographic factors, which profoundly affect population health and the use of health care facilities,25,26 had relatively little influence on achievement. Although practices that served lower-income populations had worse overall population achievement, the effect was small, and they were no more likely to use exception reporting to exclude patients than were practices with more affluent populations. Deprivation-related health inequalities therefore appear unlikely to have been greatly increased by the introduction of the financial incentive program. Smaller practices performed marginally better overall than large ones, although there was much greater variation in the performance of small practices, and many smaller practices are believed to have merged in the face of the administrative pressures from the new contract.
Imputation of rates of exception reporting was possible for only 30 of the clinical indicators (39 percent), and we cannot determine how representative these indicators were. There was a significant positive relationship between rates of exception reporting and reported achievement for these indicators, but the effect was small. It is possible that practices that were better at identifying and treating patients with chronic conditions also tended to identify more patients for whom the targets were inappropriate. Alternatively, practices may have “gamed” the new system. The generally low levels of exception reporting suggest that large-scale gaming was uncommon. However, a small minority of practices exception-reported a much larger proportion of their patients: 91 (1.1 percent) excluded over 15 percent of their patients. These practices warrant closer examination to determine whether their use of exception reporting was appropriate.
The rate of exception reporting varied considerably according to disease group. There were very low levels of exception reporting for hypothyroidism and relatively high levels for mental health problems, coronary heart disease, and chronic obstructive pulmonary disease. This variation may reflect the nature of the indicators for each disease. For example, to meet the main hypothyroidism target, practices were required to record that a patient's thyroid functions had been checked in the previous 15 months. This was a relatively easy target to meet; hence the achievement level was high and there was little reason to exclude these patients. Since the indicator carried only a modest financial reward of 6 points (£456, or $800), there was also little incentive to game. In comparison, the main mental health indicator required a review of medication, physical health, and coordination arrangements with secondary care for patients with severe long-term mental health problems. Not only would one expect legitimate exception reporting to be higher for this indicator, but the incentive to game would also be greater, since the indicator was worth 23 points (£1,748 or $3,050).
Several lessons can be drawn from the U.K. experience. First, the U.K. program was costly and was funded with substantial additional monies rather than by restructuring existing payment systems. In addition to the payments for achieving quality targets, there were further costs, to both the practitioners and the government, of developing and implementing the information-technology systems required to monitor the program. Budget-neutral programs would face greater resistance from family practitioners. Second, a clear baseline is needed to avoid paying for improvements that have already occurred. Third, geographically staggered introduction would enable policymakers to better estimate the quality effects of the program. Fourth, introducing pay-for-performance incrementally reduces risks for providers and payers. Fifth, payers should allow for the possibility of higher-than-expected achievement. Sixth, the risk of inappropriate treatment can be decreased with the use of mechanisms such as exception reporting, but monitoring is required to prevent abuse.
The U.K. experience suggests that greater changes in professional practice can be achieved through pay-for-performance programs than previous research indicates.21 We do not know whether the size of the financial incentives made the difference in the United Kingdom, and if so, how big incentives need to be. Whatever the case, financial incentives should be aligned to physicians' professional values to avoid serious distortions of care.
The views expressed are those of the authors and not necessarily those of the U.K. Department of Health.
The National Primary Care Research and Development Centre receives core funding from the U.K. Department of Health. In 2002 and 2003, Dr. Roland was a member of a small team of academics who advised the government and professional negotiating teams that developed the pay-for-performance scheme. No other potential conflict of interest relevant to this article was reported.
Source Information
From the National Primary Care Research and Development Centre, University of Manchester, Manchester, United Kingdom.
Address reprint requests to Dr. Doran at the National Primary Care Research and Development Centre, Williamson Bldg., University of Manchester, Manchester M13 9PL, United Kingdom, or at tim.doran@manchester.ac.uk.
- References
References
1
Schuster MA ,McGlynn EA ,Brook RH . How good is the quality of health care in the United States? Milbank Q 1998;76:517-563
CrossRef | Web of Science | Medline2
Seddon ME ,Marshall MN ,Campbell SM ,Roland MO . Systematic review of quality of clinical care in general practice in the UK, Australia and New Zealand. Qual Health Care 2001;10:152-158
CrossRef | Medline3
Campbell S ,Wilkin D ,Roland M . Primary care groups: improving quality of care through clinical governance. BMJ 2001;322:1580-1582
CrossRef | Web of Science | Medline4
Leatherman S, Sutherland K, eds. The quest for quality in the NHS. London: Nuffield Trust and Her Majesty's Stationery Office, 2003.
5
Roland MO, Smith J. The role and contribution of primary care trusts to quality improvement. In: Leatherman S, Sutherland K, eds. The quest for quality in the NHS. London: Nuffield Trust and Her Majesty's Stationery Office, 2003:203-24.
6
Campbell SM ,Roland MO ,Middleton E ,Reeves D . Improvements in the quality of clinical care in English general practice 1998-2003: longitudinal observational study. BMJ 2005;331:1121-1123
CrossRef | Web of Science | Medline7
Campbell SM ,Roland MO ,Shekelle PG ,Cantrill JA ,Buetow SA ,Cragg DK . The development of review criteria for assessing the quality of management of stable angina, adult asthma, and non-insulin dependent diabetes mellitus in general practice. Qual Health Care 1999;8:6-15
CrossRef | Medline8
Shekelle P . New contract for general practitioners. BMJ 2003;326:457-458
CrossRef | Web of Science | Medline9
Roland M . Linking physician pay to quality of care -- a major experiment in the United Kingdom. N Engl J Med 2004;351:1448-1454
Full Text | Web of Science | Medline10
Chaix-Couturier C ,Durand-Zaleski I ,Jolly D ,Durieux P . Effects of financial incentives on medical practice: results from a systematic review of the literature and methodological issues. Int J Qual Health Care 2000;12:133-142
CrossRef | Web of Science | Medline11
Baker D ,Middleton E . Cervical screening and health inequality in England in the 1990s. J Epidemiol Community Health 2003;57:417-423
CrossRef | Web of Science | Medline12
Middleton E ,Baker D . Comparison of social distribution of immunisation with measles, mumps, and rubella vaccine, England, 1991-2001. BMJ 2003;326:854-854
CrossRef | Web of Science | Medline13
Spooner A ,Chapple A ,Roland M . What makes British general practitioners take part in a quality improvement scheme? J Health Serv Res Policy 2001;6:145-150
CrossRef | Medline14
Roland M ,Campbell S ,Bailey N ,Whalley D ,Sibbald B . Financial incentives to improve the quality of primary care in the U.K.: predicting the consequences of change. Prim Health Care Res Dev 2006;7:18-26
CrossRef15
Starfield B . New paradigms for quality in primary care. Br J Gen Pract 2001;51:303-309
Web of Science | Medline16
British Medical Association. Focus on exception reporting. (Accessed June 28, 2006, at http://www.bma.org.uk/ap.nsf/Content/focusexcept0304.)
17
Office of the Deputy Prime Minister. Indices of Deprivation 2004. (Accessed June 28, 2006, at http://www.odpm.gov.uk/index.asp?id=1128440.)
18
McGlynn EA ,Asch SM ,Adams J , et al. The quality of health care delivered to adults in the United States. N Engl J Med 2003;348:2635-2645
Full Text | Web of Science | Medline19
Jha AK ,Perlin JB ,Steinman MA ,Peabody JW ,Ayanian JZ . Quality of ambulatory care for women and men in the Veterans Affairs health care system. J Gen Intern Med 2005;20:762-765
CrossRef | Web of Science | Medline20
Kerr EA ,Gerzoff RB ,Krein SL , et al. Diabetes care quality in the Veterans Affairs health care system and commercial managed care: the TRIAD study. Ann Intern Med 2004;141:272-281
Web of Science | Medline21
Rosenthal MB ,Frank RG ,Li Z ,Epstein AM . Early experience with pay-for-performance: from concept to practice. JAMA 2005;294:1788-1793
CrossRef | Web of Science | Medline22
The state of health care quality 2005. Washington, D.C.: National Committee for Quality Assurance, 2005.
23
Timmins N . Do GPs deserve their recent pay rise? BMJ 2005;331:800-800
CrossRef | Web of Science | Medline24
NHS Employers. The new QOF areas and indicators. (Accessed June 28, 2006, at http://www.nhsemployers.org/primary/primary-886.cfm.)
25
Marmot M ,Davey Smith G . Socioeconomic differentials in health: the contribution of the Whitehall studies. J Health Psychol 1997;2:283-296
CrossRef | Medline26
Amick B, Levine S, Tarlov A, Walsh D. Community and health. In: Patrick D, Wickizer T, eds. Society and health. Oxford, England: Oxford University Press, 1995:46-92.
- Citing Articles (147)
Citing Articles
1
Evangelos Kontopantelis, Tim Doran, Hugh Gravelle, Rosalind Goudie, Luigi Siciliani, Matt Sutton. (2012) Family Doctor Responses to Changes in Incentives for Influenza Immunization under the U.K. Quality and Outcomes Framework Pay-for-Performance Scheme. Health Services Research 47:3pt1, 1117-1136
CrossRef2
Maureen T. Stewart, Constance M. Horgan, Deborah W. Garnick, Grant Ritter, A. Thomas McLellan. (2012) Performance contracting and quality improvement in outpatient treatment: Effects on waiting time and length of stay. Journal of Substance Abuse Treatment
CrossRef3
Marion Bennie, Brian Godman, Iain Bishop, Stephen Campbell. (2012) Multiple initiatives continue to enhance the prescribing efficiency for the proton pump inhibitors and statins in Scotland. Expert Review of Pharmacoeconomics & Outcomes Research 12:1, 125-130
CrossRef4
Mohammed Abuelkhair, Shajahan Abdu, Brian Godman, Sahar Fahmy, Rickard E Malmström, Lars L Gustafsson. (2012) Imperative to consider multiple initiatives to maximize prescribing efficiency from generic availability: case history from Abu Dhabi. Expert Review of Pharmacoeconomics & Outcomes Research 12:1, 115-124
CrossRef5
M. Rahman, R. K. Simmons, S. H. Hennings, N. J. Wareham, S. J. Griffin. (2012) How much does screening bring forward the diagnosis of type 2 diabetes and reduce complications? Twelve year follow-up of the Ely cohort. Diabetologia
CrossRef6
N. Chauvel, M. Le Vaillant, N. Pelletier-Fleury. (2012) Variation in HbA1c prescription for patients with diabetes in French general practice: an observational study prior to the implementation of a P4P programme. The European Journal of Public Health
CrossRef7
Alan Maynard. (2012) The powers and pitfalls of payment for performance. Health Economics 21:1, 3-12
CrossRef8
David L Carpenter, Sara R Gregg, Daniel S Owens, Timothy G Buchman, Craig M Coopersmith. (2012) Patient care time allocation by nurse practitioners and physician assistants in the intensive care unit. Critical Care 16:1, R27
CrossRef9
T. G. K. Bentley, J. Malin, S. Longino, S. Asch, S. Dy, K. A. Lorenz. (2011) Methods for improving efficiency in quality measurement: the example of pain screening. International Journal for Quality in Health Care 23:6, 657-663
CrossRef10
Adam A. Powell, Katie M. White, Melissa R. Partin, Krysten Halek, Jon B. Christianson, Brian Neil, Sylvia J. Hysong, Edwin J. Zarling, Hanna E. Bloomfield. (2011) Unintended Consequences of Implementing a National Performance Measurement System into Local Practice. Journal of General Internal Medicine
CrossRef11
Peter Griffiths, Jill Maben, Trevor Murrells. (2011) Organisational quality, nurse staffing and the quality of chronic disease management in primary care: Observational study using routinely collected data. International Journal of Nursing Studies 48:10, 1199-1210
CrossRef12
Luis Palomo, Joan Gené-Badia, Juan José Rodríguez-Sendín. (2011) La reforma de la atención primaria, entre el refugio del pasado y la aventura de la innovación. Informe SESPAS 2012. Gaceta Sanitaria
CrossRef13
Stephen Buetow, Vikki Entwistle. (2011) Pay-for-virtue: an option to improve pay-for-performance?. Journal of Evaluation in Clinical Practice 17:5, 894-898
CrossRef14
Anthony Scott, Peter Sivey, Driss Ait Ouakrim, Lisa Willenberg, Lucio Naccarella, John Furler, Doris Young, Anthony Scott. 2011. The effect of financial incentives on the quality of health care provided by primary care physicians. .
CrossRef15
Eva Thors Adolfsson, Andreas Rosenblad. (2011) Reporting systems, reporting rates and completeness of data reported from primary healthcare to a Swedish quality register – The National Diabetes Register. International Journal of Medical Informatics 80:9, 663-668
CrossRef16
Mark Dusheiko, Hugh Gravelle, Stephen Martin, Nigel Rice, Peter C. Smith. (2011) Does better disease management in primary care reduce hospital costs? Evidence from English primary care. Journal of Health Economics 30:5, 919-932
CrossRef17
D. Gorman, M. Thompson. (2011) Encouraging and rewarding the good behaviour of healthcare providers. Internal Medicine Journal 41:8, 585-587
CrossRef18
Josep Redon, Serap Erdine, Michael Böhm, Claudio Ferri, Rainer Kolloch, Reinhold Kreutz, Stéphane Laurent, Alexandre Persu, Roland E. Schmieder. (2011) Physician attitudes to blood pressure control. Journal of Hypertension 29:8, 1633-1640
CrossRef19
Gianluca Fiorentini, Elisa Iezzi, Matteo Lippi Bruni, Cristina Ugolini. (2011) Incentives in primary care and their impact on potentially avoidable hospital admissions. The European Journal of Health Economics 12:4, 297-309
CrossRef20
Cheng Li, Xuan Yu, James R.G. Butler, Vasoontara Yiengprugsawan, Min Yu. (2011) Moving towards universal health insurance in China: Performance, issues and lessons from Thailand. Social Science & Medicine 73:3, 359-366
CrossRef21
Luka Vončina, Tihomir Strizrep, Brian Godman, Marion Bennie, Iain Bishop, Stephen Campbell, Vera Vlahović-Palčevski, Lars L Gustafsson. (2011) Influence of demand-side measures to enhance renin–angiotensin prescribing efficiency in Europe: implications for the future. Expert Review of Pharmacoeconomics & Outcomes Research 11:4, 469-479
CrossRef22
Simon J Griffin, Knut Borch-Johnsen, Melanie J Davies, Kamlesh Khunti, Guy EHM Rutten, Annelli Sandbæk, Stephen J Sharp, Rebecca K Simmons, Maureen van den Donk, Nicholas J Wareham, Torsten Lauritzen. (2011) Effect of early intensive multifactorial therapy on 5-year cardiovascular outcomes in individuals with type 2 diabetes detected by screening (ADDITION-Europe): a cluster-randomised trial. The Lancet 378:9786, 156-167
CrossRef23
Martin Emmert, Frank Eijkenaar, Heike Kemter, Adelheid Susanne Esslinger, Oliver Schöffski. (2011) Economic evaluation of pay-for-performance in health care: a systematic review. The European Journal of Health Economics
CrossRef24
E. Gowin, T. Pawlikowska, W. Horst-Sikorska, M. Michalak. (2011) British and Polish general practitioners' opinions on the importance of preventive medicine. Health Promotion International 26:2, 171-176
CrossRef25
Christine Patch, Judith Charlton, Paul J. Roderick, Martin C. Gulliford. (2011) Use of Antihypertensive Medications and Mortality of Patients With Autosomal Dominant Polycystic Kidney Disease: A Population-Based Study. American Journal of Kidney Diseases 57:6, 856-862
CrossRef26
Joan Gené Badia. (2011) El pago por desempeño no mejora el control de la tensión arterial. FMC - Formación Médica Continuada en Atención Primaria 18:5, 315
CrossRef27
A. R. H. Dalton, R. Alshamsan, A. Majeed, C. Millett. (2011) Exclusion of patients from quality measurement of diabetes care in the UK pay-for-performance programme. Diabetic Medicine 28:5, 525-531
CrossRef28
Paulin Basinga, Paul J Gertler, Agnes Binagwaho, Agnes LB Soucat, Jennifer Sturdy, Christel MJ Vermeersch. (2011) Effect on maternal and child health services in Rwanda of payment to primary health-care providers for performance: an impact evaluation. The Lancet 377:9775, 1421-1428
CrossRef29
M. Olmo, L. Galvan, J. Capdevila, C. Serna, I. Mangues, J.A. Schoenenberger. (2011) Dirección por objetivos y su impacto sobre la calidad de la prescripción de los especialistas al alta y en consultas externas. Farmacia Hospitalaria 35:2, 58-63
CrossRef30
Celita Begbie, Mark Bussin, Willem Schurink. (2011) A foodmanufacturing manager’s experiences and perceptions of the implementation of an incentive scheme. SA Journal of Human Resource Management 9:1,
CrossRef31
Stephen Morris, Rosalind Goudie, Matt Sutton, Hugh Gravelle, Robert Elliott, Arne Risa Hole, Ada Ma, Bonnie Sibbald, Diane Skåtun. (2011) Determinants of general practitioners' wages in England. Health Economics 20:2, 147-160
CrossRef32
Tsung-Tai Chen, Kuo-Piao Chung, I-Chin Lin, Mei-Shu Lai. (2011) The Unintended Consequence of Diabetes Mellitus Pay-for-Performance (P4P) Program in Taiwan: Are Patients with More Comorbidities or More Severe Conditions Likely to Be Excluded from the P4P Program?. Health Services Research 46:1p1, 47-60
CrossRef33
M. Schrappe, N. Gültekin. (2011) Pay for Performance (P4P). Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 54:2, 166-170
CrossRef34
Thomas D. Sequist, Eric C. Schneider, Angela Li, William H. Rogers, Dana Gelb Safran. (2011) Reliability of Medical Group and Physician Performance Measurement in the Primary Care Setting. Medical Care 49:2, 126-131
CrossRef35
Oddvar Kaarboe, Luigi Siciliani. (2011) Multi-tasking, quality and pay for performance. Health Economics 20:2, 225-238
CrossRef36
Takahiro Higashi, Shunichi Fukuhara, Takeo Nakayama. (2011) Opinion of Japanese rheumatology physicians on methods of assessing the quality of rheumatoid arthritis care. Journal of Evaluation in Clinical Practiceno-no
CrossRef37
Pauline Boeckxstaens, Delphine De Smedt, Jan De Maeseneer, Lieven Annemans, Sara Willems. (2011) The equity dimension in evaluations of the quality and outcomes framework: A systematic review. BMC Health Services Research 11:1, 209
CrossRef38
M. Olmo, L. Galvan, J. Capdevila, C. Serna, I. Mangues, J.A. Schoenenberger. (2011) Management by objectives and its impact on specialist prescription quality at discharge and in external consultations. Farmacia Hospitalaria (English Edition) 35:2, 58-63
CrossRef39
Stephen M Campbell, Evangelos Kontopantelis, Kerin Hannon, Martyn Burke, Annette Barber, Helen E Lester. (2011) Framework and indicator testing protocol for developing and piloting quality indicators for the UK quality and outcomes framework. BMC Family Practice 12:1, 85
CrossRef40
Laura A Petersen, Tracy Urech, Kate Simpson, Kenneth Pietz, Sylvia J Hysong, Jochen Profit, Douglas Conrad, R Adams Dudley, Meghan Z Lutschg, Robert Petzel, LeChauncy D Woodard. (2011) Design, rationale, and baseline characteristics of a cluster randomized controlled trial of pay for performance for hypertension treatment: study protocol. Implementation Science 6:1, 114
CrossRef41
David Dranove. 2011. Health Care Markets, Regulators, and Certifiers. , 639-690.
CrossRef42
Robbie Foy, Martin P Eccles, Susan Hrisos, Gillian Hawthorne, Nick Steen, Ian Gibb, Bernard Croal, Jeremy Grimshaw. (2011) A cluster randomised trial of educational messages to improve the primary care of diabetes. Implementation Science 6:1, 129
CrossRef43
Allison Worth, Hilary Pinnock, Monica Fletcher, Gaylor Hoskins, Mark L Levy, Aziz Sheikh. (2011) Systems for the management of respiratory disease in primary care – an international series: United Kingdom. Primary Care Respiratory Journal 20:1, 23
CrossRef44
Ronald Donato, Leonie Segal. (2010) The economics of primary healthcare reform in Australia - towards single fundholding through development of primary care organisations. Australian and New Zealand Journal of Public Health 34:6, 613-619
CrossRef45
Lisa I. Iezzoni. (2010) Multiple Chronic Conditions and Disabilities: Implications for Health Services Research and Data Demands. Health Services Research 45:5p2, 1523-1540
CrossRef46
Alessandro Filippi, Manuela Casula, Elena Tragni, Ovidio Brignoli, Claudio Cricelli, Andrea Poli, Alberico Luigi Catapano. (2010) Blood pressure and antihypertensive therapy according to the global cardiovascular risk level in Italy: the CHECK Study. European Journal of Cardiovascular Prevention & Rehabilitation 17:5, 562-568
CrossRef47
Julia Lowe, Julie Byles, Xenia Dolja-Gore, Anne Young. (2010) Does systematically organized care improve outcomes for women with diabetes?. Journal of Evaluation in Clinical Practice 16:5, 887-894
CrossRef48
L. A. Sargeant, R. K. Simmons, R. S. Barling, R. Butler, K. M. Williams, A. T. Prevost, A. L. Kinmonth, N. J. Wareham, S. J. Griffin. (2010) Who attends a UK diabetes screening programme? Findings from the ADDITION-Cambridge study. Diabetic Medicine 27:9, 995-1003
CrossRef49
J. Murray, S. Saxena, C. Millett, V. Curcin, S. de Lusignan, A. Majeed. (2010) Reductions in risk factors for secondary prevention of coronary heart disease by ethnic group in south-west London: 10-year longitudinal study (1998-2007). Family Practice 27:4, 430-438
CrossRef50
Katrine B. Frønsdal, Karen Facey, Marianne Klemp, Inger Natvig Norderhaug, Berit Mørland, John-Arne Røttingen. (2010) Health technology assessment to optimize health technology utilization: Using implementation initiatives and monitoring processes. International Journal of Technology Assessment in Health Care 26:03, 309-316
CrossRef51
Kurt C. Stange, Paul A. Nutting, William L. Miller, Carlos R. Jaén, Benjamin F. Crabtree, Susan A. Flocke, James M. Gill. (2010) Defining and Measuring the Patient-Centered Medical Home. Journal of General Internal Medicine 25:6, 601-612
CrossRef52
U. Chauhan, E. Kontopantelis, S. Campbell, H. Jarrett, H. Lester. (2010) Health checks in primary care for adults with intellectual disabilities: how extensive should they be?. Journal of Intellectual Disability Research 54:6, 479-486
CrossRef53
M. A. Stone, J. Camosso-Stefinovic, J. Wilkinson, S. de Lusignan, A. T. Hattersley, K. Khunti. (2010) Incorrect and incomplete coding and classification of diabetes: a systematic review. Diabetic Medicine 27:5, 491-497
CrossRef54
A. S Abdelhamid, S. Maisey, N. Steel. (2010) Predictors of the quality of care for asthma in general practice: an observational study. Family Practice 27:2, 186-191
CrossRef55
Sukyung Chung, Latha Palaniappan, Eric Wong, Haya Rubin, Harold Luft. (2010) Does the Frequency of Pay-for-Performance Payment Matter?-Experience from a Randomized Trial. Health Services Research 45:2, 553-564
CrossRef56
Kathleen J. Mullen, Richard G. Frank, Meredith B. Rosenthal. (2010) Can you get what you pay for? Pay-for-performance and the quality of healthcare providers. The RAND Journal of Economics 41:1, 64-91
CrossRef57
Alan R. Spitzer. (2010) Pay for Performance in Neonatal-Perinatal Medicine—Will the Quality of Health Care Improve in the Neonatal Intensive Care Unit? A Business Model for Improving Outcomes in the Neonatal Intensive Care Unit. Clinics in Perinatology 37:1, 167-177
CrossRef58
Winnie Chi-Man Yip, William Hsiao, Qingyue Meng, Wen Chen, Xiaoming Sun. (2010) Realignment of incentives for health-care providers in China. The Lancet 375:9720, 1120-1130
CrossRef59
Mark E. Patterson, Adrian F. Hernandez, Bradley G. Hammill, Gregg C. Fonarow, Eric D. Peterson, Kevin A. Schulman, Lesley H. Curtis. (2010) Process of Care Performance Measures and Long-Term Outcomes in Patients Hospitalized With Heart Failure. Medical Care 48:3, 210-216
CrossRef60
Hugh Gravelle, Matt Sutton, Ada Ma. (2010) Doctor Behaviour under a Pay for Performance Contract: Treating, Cheating and Case Finding?. The Economic Journal 120:542, F129-F156
CrossRef61
Diane McGinn, Brian Godman, Julie Lonsdale, Rosalind Way, Björn Wettermark, Alan Haycox. (2010) Initiatives to enhance the quality and efficiency of statin and PPI prescribing in the UK: impact and implications. Expert Review of Pharmacoeconomics & Outcomes Research 10:1, 73-85
CrossRef62
M.A. Stone, J.C. Wilkinson, G. Charpentier, N. Clochard, G. Grassi, U. Lindblad, U.A. Müller, J. Nolan, G.E. Rutten, K. Khunti. (2010) Evaluation and comparison of guidelines for the management of people with type 2 diabetes from eight European countries. Diabetes Research and Clinical Practice 87:2, 252-260
CrossRef63
A. L Terry, V. Chevendra, A. Thind, M. Stewart, J N. Marshall, S. Cejic. (2010) Using your electronic medical record for research: a primer for avoiding pitfalls. Family Practice 27:1, 121-126
CrossRef64
Andrew M. Ryan. (2010) Has Pay-for-Performance Decreased Access for Minority Patients?. Health Services Research 45:1, 6-23
CrossRef65
Chris Ham. (2010) The ten characteristics of the high-performing chronic care system. Health Economics, Policy and Law 5:01, 71
CrossRef66
Katharina Janus. 2010. Managing motivation among health care professionals. , 47-77.
CrossRef67
Alyson L. Mahar, Alia P. Qureshi, C. Andrea Ottensmeyer, Runjan Chetty, Aaron Pollett, Natalie G. Coburn, Frances C. Wright. (2010) Improving the quality of processing gastric cancer specimens: The pathologist's perspective. Journal of Surgical Oncologyn/a-n/a
CrossRef68
N. M. Hawkins, P. S. Jhund, C. R. Simpson, M. C. Petrie, M. R. MacDonald, F. G. Dunn, K. MacIntyre, J. J.V. McMurray. (2010) Primary care burden and treatment of patients with heart failure and chronic obstructive pulmonary disease in Scotland. European Journal of Heart Failure 12:1, 17-24
CrossRef69
Israel Rabinowitz, Ohad Hochman, Rachel Luzzati, Yelena Haifitz, Yuri Shclar, Natalia Kaykov, Alexander Khemlin, Michael Kaffman, Ada Tamir. (2010) Monitoring and treatment for cardiovascular risk. Primary Health Care Research & Development 11:01, 29
CrossRef70
Michael Kuhn, Luigi Siciliani. (2009) Performance Indicators for Quality with Costly Falsification. Journal of Economics & Management Strategy 18:4, 1137-1154
CrossRef71
Hector P. Rodriguez, Ted Glahn, Marc N. Elliott, William H. Rogers, Dana Gelb Safran. (2009) The Effect of Performance-Based Financial Incentives on Improving Patient Care Experiences: A Statewide Evaluation. Journal of General Internal Medicine 24:12, 1281-1288
CrossRef72
Keiko Asao, Ishak A. Mansi, Daniel Banks. (2009) Improving Quality in an Internal Medicine Residency Program Through a Peer Medical Record Audit. Academic Medicine 84:12, 1796-1802
CrossRef73
Naomi S Bardach, Michael D Cabana. (2009) The unintended consequences of quality improvement. Current Opinion in Pediatrics 21:6, 777-782
CrossRef74
J. C Crosson, P. A Ohman-Strickland, S. Campbell, R. L Phillips, M. O Roland, E. Kontopantelis, A. Bazemore, B. Balasubramanian, B. F Crabtree. (2009) A comparison of chronic illness care quality in US and UK family medicine practices prior to pay-for-performance initiatives. Family Practice 26:6, 510-516
CrossRef75
A Filippi, I Paolini, F Innocenti, G Mazzaglia, A Battaggia, O Brignoli. (2009) Blood pressure control and drug therapy in patients with diagnosed hypertension: a survey in Italian general practice. Journal of Human Hypertension 23:11, 758-763
CrossRef76
Seth W. Glickman, William Boulding, Jason M. T. Roos, Richard Staelin, Eric D. Peterson, Kevin A. Schulman. (2009) Alternative Pay-for-Performance Scoring Methods. Medical Care 47:10, 1062-1068
CrossRef77
Andrew Egol, Aryeh Shander, Lisa Kirkland, Michael H. Wall, Todd Dorman, Joe Dasta, Sandra Bagwell, David Kaufman, Paul Matthews, Bruce M. Greenwald, Daniel L. Herr, Cynthia Stavish, Carol Thompson, Brenda G. Fahy. (2009) Pay for performance in critical care: An executive summary of the position paper by the Society of Critical Care Medicine*. Critical Care Medicine 37:9, 2625-2631
CrossRef78
Anthony Scott, Stefanie Schurer, Paul H. Jensen, Peter Sivey. (2009) The effects of an incentive program on quality of care in diabetes management. Health Economics 18:9, 1091-1108
CrossRef79
C. Norman, R. Zarrinkoub, J. Hasselström, B. Godman, F. Granath, B. Wettermark. (2009) Potential savings without compromising the quality of care. International Journal of Clinical Practice 63:9, 1320-1326
CrossRef80
Nicholas Spoerke, Robert Martindale. (2009) Should the principle of “pay for performance” be applied to nutrition support?. Current Gastroenterology Reports 11:4, 332-335
CrossRef81
Erik K. Mayer, Andre Chow, Justin A. Vale, Thanos Athanasiou. (2009) Appraising the Quality of Care in Surgery. World Journal of Surgery 33:8, 1584-1593
CrossRef82
Benjamin D. Smith, Grace L. Smith, Kenneth B. Roberts, Thomas A. Buchholz. (2009) Baseline Utilization of Breast Radiotherapy Before Institution of the Medicare Practice Quality Reporting Initiative. International Journal of Radiation Oncology*Biology*Physics 74:5, 1506-1512
CrossRef83
David C. Miller, Christopher S. Saigal. (2009) Quality of care indicators for prostate cancer: Progress toward consensus. Urologic Oncology: Seminars and Original Investigations 27:4, 427-434
CrossRef84
R. Mojtabai, L. Fochtmann, S.-W. Chang, R. Kotov, T. J. Craig, E. Bromet. (2009) Unmet Need for Mental Health Care in Schizophrenia: An Overview of Literature and New Data From a First-Admission Study. Schizophrenia Bulletin 35:4, 679-695
CrossRef85
LAURA FENTON, BRIAN SALTER. (2009) Competition and compromise in negotiating the new governance of medical performance: the clinical governance and revalidation policies in the UK. Health Economics, Policy and Law 4:03, 283
CrossRef86
Allison B. Rosen, David M. Cutler. (2009) Challenges in Building Disease-Based National Health Accounts. Medical Care 47:Supplement, S7-S13
CrossRef87
Matthew K. Wynia. (2009) The Risks of Rewards in Health Care: How Pay-for-performance Could Threaten, or Bolster, Medical Professionalism. Journal of General Internal Medicine 24:7, 884-887
CrossRef88
Thomas Foels, Sharon Hewner. (2009) Integrating Pay for Performance with Educational Strategies to Improve Diabetes Care. Population Health Management 12:3, 121-129
CrossRef89
Justin W. Timbie, David M. Shahian, Joseph P. Newhouse, Meredith B. Rosenthal, Sharon-Lise T. Normand. (2009) Composite measures for hospital quality using quality-adjusted life years. Statistics in Medicine 28:8, 1238-1254
CrossRef90
Douglas A. Conrad, Lisa Perry. (2009) Quality-Based Financial Incentives in Health Care: Can We Improve Quality by Paying for It?. Annual Review of Public Health 30:1, 357-371
CrossRef91
Loren Riskin, Jason A Campagna. (2009) Quality assessment by external bodies: intended and unintended impact on healthcare delivery. Current Opinion in Anaesthesiology 22:2, 237-241
CrossRef92
Islay Gemmell, Stephen Campbell, Mark Hann, Bonnie Sibbald. (2009) Assessing workload in general practice in England before and after the introduction of the pay-for-performance contract. Journal of Advanced Nursing 65:3, 509-515
CrossRef93
Kristina Khanduja, Damon C. Scales, Neill K. J. Adhikari. (2009) Pay for performance in the intensive care unit—Opportunity or threat?*. Critical Care Medicine 37:3, 852-858
CrossRef94
Jennifer E. DeVoe, Lorraine S. Wallace, George E. Fryer Jr. (2009) Measuring patients’ perceptions of communication with healthcare providers: Do differences in demographic and socioeconomic characteristics matter?. Health Expectations 12:1, 70-80
CrossRef95
Jeffrey A. Linder, Erin O. Kaleba, Karen S. Kmetik. (2009) Using Electronic Health Records to Measure Physician Performance for Acute Conditions in Primary Care. Medical Care 47:2, 208-216
CrossRef96
Christopher Millett, Jeremy Gray, Martin Wall, Azeem Majeed. (2009) Ethnic Disparities in Coronary Heart Disease Management and Pay for Performance in the UK. Journal of General Internal Medicine 24:1, 8-13
CrossRef97
Jamie John Kirkham, Omar Bouamra. (2008) The Use of Statistical Process Control for Monitoring Institutional Performance in Trauma Care. The Journal of Trauma: Injury, Infection, and Critical Care 65:6, 1494-1501
CrossRef98
J. B. Echouffo-Tcheugui, L. A. Sargeant, A. T. Prevost, K. M. Williams, R. S. Barling, R. Butler, T. Fanshawe, A. L. Kinmonth, N. J. Wareham, S. J. Griffin. (2008) How much might cardiovascular disease risk be reduced by intensive therapy in people with screen-detected diabetes?. Diabetic Medicine 25:12, 1433-1439
CrossRef99
Thomas D. Sequist, Eric C. Schneider, Michael Anastario, Esosa G. Odigie, Richard Marshall, William H. Rogers, Dana Gelb Safran. (2008) Quality Monitoring of Physicians: Linking Patients’ Experiences of Care to Clinical Quality and Outcomes. Journal of General Internal Medicine 23:11, 1784-1790
CrossRef100
Judith A. Long, Marie Helweg-Larsen, Kevin G. Volpp. (2008) Patient Opinions Regarding ‘Pay for Performance for Patients’. Journal of General Internal Medicine 23:10, 1647-1652
CrossRef101
Rachel M. Werner, Eric T. Bradlow, David A. Asch. (2008) Does Hospital Performance on Process Measures Directly Measure High Quality Care or Is It a Marker of Unmeasured Care?. Health Services Research 43:5p1, 1464-1484
CrossRef102
Raisa Deber, Marcus J. Hollander, Philip Jacobs. (2008) Models of funding and reimbursement in health care: A conceptual framework. Canadian Public Administration 51:3, 381-405
CrossRef103
S. W Pascoe, R. D Neal, P. L Heywood, V. L Allgar, J. N. Miles, J. Stefoski-Mikeljevic. (2008) Identifying patients with a cancer diagnosis using general practice medical records and Cancer Registry data. Family Practice 25:4, 215-220
CrossRef104
Doran, Tim, Fullwood, Catherine, Reeves, David, Gravelle, Hugh, Roland, Martin, . (2008) Exclusion of Patients from Pay-for-Performance Targets by English Physicians. New England Journal of Medicine 359:3, 274-284
Full Text105
DAVID MECHANIC. (2008) Rethinking Medical Professionalism: The Role of Information Technology and Practice Innovations. The Milbank Quarterly 86:2, 327-358
CrossRef106
L Dolovich, K Pottie, J Kaczorowski, B Farrell, Z Austin, C Rodriguez, K Gaebel, C Sellors. (2008) Integrating Family Medicine and Pharmacy to Advance Primary Care Therapeutics. Clinical Pharmacology & Therapeutics 83:6, 913-917
CrossRef107
Michael Schatz. (2008) Does pay-for-performance influence the quality of care?. Current Opinion in Allergy and Clinical Immunology 8:3, 213-221
CrossRef108
Adrian F. Hernandez, Gregg C. Fonarow. (2008) Translating Evidence into Practice: Use of Statins in Real-World Patients with Heart Failure. Heart Failure Clinics 4:2, 217-223
CrossRef109
Jinoos Yazdany, Catherine H MacLean. (2008) Quality of care in the rheumatic diseases: current status and future directions. Current Opinion in Rheumatology 20:2, 159-166
CrossRef110
Alex Bottle, Shamini Gnani, Sonia Saxena, Paul Aylin, Arch G. Mainous, Azeem Majeed. (2008) Association Between Quality of Primary Care and Hospitalization for Coronary Heart Disease in England: National Cross-sectional Study. Journal of General Internal Medicine 23:2, 135-141
CrossRef111
A. John Orzano, Claire R. McInerney, Davida Scharf, Alfred F. Tallia, Benjamin F. Crabtree. (2008) A knowledge management model: Implications for enhancing quality in health care. Journal of the American Society for Information Science and Technology 59:3, 489-505
CrossRef112
A. Mason. (2008) New medicines in primary care: a review of influences on general practitioner prescribing. Journal of Clinical Pharmacy and Therapeutics 33:1, 1-10
CrossRef113
Stephen Buetow. (2008) Pay-for-performance in New Zealand primary health care. Journal of Health Organisation and Management 22:1, 36-47
CrossRef114
Revital Gross, Asher Elhaynay, Nurit Friedman, Stephen Buetow. (2008) Pay-for-performance programs in Israeli sick funds. Journal of Health Organisation and Management 22:1, 23-35
CrossRef115
Jennifer A Meddings, Laurence F McMahon. (2008) Measuring Quality in Pay-for-Performance Programs. Disease Management & Health Outcomes 16:4, 205-216
CrossRef116
Tim Doran. (2008) Lessons from Early Experience with Pay for Performance. Disease Management & Health Outcomes 16:2, 69-77
CrossRef117
Ruth McDonald, Stephen Harrison, Kath Checkland. (2008) Incentives and control in primary health care: findings from English pay-for-performance case studies. Journal of Health Organisation and Management 22:1, 48-62
CrossRef118
Iain M Carey, Stephen De Wilde, Tess Harris, Christina Victor, Nicky Richards, Sean R Hilton, Derek G Cook. (2008) What Factors Predict Potentially Inappropriate Primary Care Prescribing in Older People?. Drugs & Aging 25:8, 693-706
CrossRef119
Ruth Wintz, Brian Rosenthal, Stephen Z. Fadem. (2008) The Physician Quality Reporting Initiative: A Practical Approach to Implementing Quality Reporting. Advances in Chronic Kidney Disease 15:1, 56-63
CrossRef120
M. Pirson, P. Leclercq, T. Jackson, M. Leclercq, M. Garrino, C. Sion. (2008) Financial consequences of hospital-acquired bacteraemia in three Belgian hospitals in 2003 and 2004. Journal of Hospital Infection 68:1, 9-16
CrossRef121
Benjamin J. Powers, Carolyn T. Thorpe, Hayden B. Bosworth. (2008) Complex chronic care: Patient, provider and organisational issues. Journal of Management & Marketing in Healthcare 1:2, 179-190
CrossRef122
K. Khunti, R. Gadsby, C. Millett, A. Majeed, M. Davies. (2007) Quality of diabetes care in the UK: comparison of published quality-of-care reports with results of the Quality and Outcomes Framework for Diabetes. Diabetic Medicine 24:12, 1436-1441
CrossRef123
Janak A. Parikh, Irina Yermilov, Sushma Jain, Marcia L. McGory, Clifford Y. Ko, Melinda A. Maggard. (2007) How Much Do Standardized Forms Improve the Documentation of Quality of Care?. Journal of Surgical Research 143:1, 158-163
CrossRef124
Kathleen M. Dungan, Tia Guster, Darren A. DeWalt, John B. Buse. (2007) A comparison of lipid and lipoprotein measurements in the fasting and nonfasting states in patients with type 2 diabetes*. Current Medical Research and Opinion 23:11, 2689-2695
CrossRef125
Tomasz J. Kuzniar, Jason M. Golbin, Timothy I. Morgenthaler. (2007) Moving beyond empiric continuous positive airway pressure (CPAP) trials for central sleep apnea: a multi-modality titration study. Sleep and Breathing 11:4, 259-266
CrossRef126
RANDALL P. ELLIS, MARIAN VIDAL-FERNÁNDEZ. (2007) Activity-based payments and reforms of the English hospital payment system. Health Economics, Policy and Law 2:04,
CrossRef127
Tim Doran, Catherine Fullwood. (2007) Pay for performance: Is it the best way to improve control of hypertension?. Current Hypertension Reports 9:5, 360-367
CrossRef128
C. Brand, I. Scott, P. Greenberg, P. Sargious. (2007) Chronic disease management: time for consultant physicians to take more leadership in system redesign. Internal Medicine Journal 37:9, 653-659
CrossRef129
Jeremy Gray, Christopher Millett, Sonia Saxena, Gopalakrishnan Netuveli, Kamlesh Khunti, Azeem Majeed. (2007) Ethnicity and Quality of Diabetes Care in a Health System with Universal Coverage: Population-Based Cross-sectional Survey in Primary Care. Journal of General Internal Medicine 22:9, 1317-1320
CrossRef130
Meredith B Rosenthal. (2007) Pay for performance and beyond. Expert Review of Pharmacoeconomics & Outcomes Research 7:4, 351-355
CrossRef131
Gonzalo Varela. (2007) Pay for Performance in Thoracic Surgery. Thoracic Surgery Clinics 17:3, 431-435
CrossRef132
Campbell, Stephen, Reeves, David, Kontopantelis, Evangelos, Middleton, Elizabeth, Sibbald, Bonnie, Roland, Martin, . (2007) Quality of Primary Care in England with the Introduction of Pay for Performance. New England Journal of Medicine 357:2, 181-190
Full Text133
Rachel M. Werner, Sheldon Greenfield, Constance Fung, Barbara J. Turner. (2007) Measuring Quality of Care in Patients With Multiple Clinical Conditions: Summary of a Conference Conducted by the Society of General Internal Medicine. Journal of General Internal Medicine 22:8, 1206-1211
CrossRef134
Celia Shohet, Julia Yelloly, Paul Bingham, Georgios Lyratzopoulos. (2007) The association between the quality of epilepsy management in primary care, general practice population deprivation status and epilepsy-related emergency hospitalisations. Seizure 16:4, 351-355
CrossRef135
Richard G. Roberts. (2007) Evaluación y mejora de la calidad asistencial: las personas no son coches. Atención Primaria 39:6, 279-282
CrossRef136
David C. Miller, Benjamin A. Spencer, Jamie Ritchey, Andrew K. Stewart, Rodney L. Dunn, Howard M. Sandler, John T. Wei, Mark S. Litwin. (2007) Treatment Choice and Quality of Care for Men With Localized Prostate Cancer. Medical Care 45:5, 401-409
CrossRef137
Allan H. Goroll, Robert A. Berenson, Stephen C. Schoenbaum, Laurence B. Gardner. (2007) Fundamental Reform of Payment for Adult Primary Care: Comprehensive Payment for Comprehensive Care. Journal of General Internal Medicine 22:3, 410-415
CrossRef138
N. Reed Dunnick, Kimberly E. Applegate, Ronald L. Arenson. (2007) Quality—A Radiology Imperative: Report of the 2006 Intersociety Conference. Journal of the American College of Radiology 4:3, 156-161
CrossRef139
Baiju R. Shah, Janet E. Hux, Andreas Laupacis, Bernard Zinman, Merrick Zwarenstein. (2007) Deficiencies in the Quality of Diabetes Care. Journal of General Internal Medicine 22:2, 275-279
CrossRef140
Epstein, Arnold M., . (2007) Pay for Performance at the Tipping Point. New England Journal of Medicine 356:5, 515-517
Full Text141
Richard Amerling, James F. Winchester, Claudio Ronco. (2007) Guidelines for Guidelines. Blood Purification 25:1, 36-38
CrossRef142
Vicente Ortún Rubio. (2007) Los incentivos para la mejora de la calidad en los servicios de salud. Revista de Calidad Asistencial 22:1, 1-6
CrossRef143
Constance Liu, Brook Watts, David Litaker. (2006) Access to and utilization of healthcare: the provider’s role. Expert Review of Pharmacoeconomics & Outcomes Research 6:6, 653-660
CrossRef144
(2006) Pay-for-Performance Programs in the United Kingdom. New England Journal of Medicine 355:17, 1832-1833
Full Text145
Roger Gadsby. (2006) How effective are processes of care for the treatment of diabetes?. Nature Clinical Practice Endocrinology & Metabolism 2:10, 546-547
CrossRef146
. (2006) Weinig gesjoemel Engelse huisartsen. Huisarts en Wetenschap 49:10, 698-698
CrossRef147
Epstein, Arnold M., . (2006) Paying for Performance in the United States and Abroad. New England Journal of Medicine 355:4, 406-408
Full Text
- Letters
