Spending by primary care practices-does it show what we expect?
Background Over recent years, a number of policies and financial incentives in primary care have been proposed to tackle issues such as deprivation and health outcomes. This article investigates the association between healthcare spending, deprivation and outcomes. It argues that individual practic...
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| Format: | Article |
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Wiley
2013
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| Online Access: | https://eprints.nottingham.ac.uk/41398/ |
| _version_ | 1848796265528164352 |
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| author | James, Marilyn Stokes, Elizabeth |
| author_facet | James, Marilyn Stokes, Elizabeth |
| author_sort | James, Marilyn |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background
Over recent years, a number of policies and financial incentives in primary care have been proposed to tackle issues such as deprivation and health outcomes. This article investigates the association between healthcare spending, deprivation and outcomes. It argues that individual practice data are analysed before blanket application and acceptance that one size fits all in a local area.
Methods
Financial data were analysed alongside key outcome data, including quality and outcomes framework (QOF) indicators for a large urban primary care trust (PCT) in the UK. The PCT had a large population and number of practices, including single-handed practices and an average list size in excess of 5000. The PCT will remain anonymous.
Results
There was no relationship between primary care investment and the practices' deprivation score. There was a strong statistically significant negative correlation between QOF payments and deprivation, (correlation = −0.46, p < 0.001). There were only weak links between primary care investment and health outcomes. There was no relationship between high emergency spending and health outcome.
Conclusions
The data presented suggest that one size does not necessarily fit all—in terms of providing the appropriate incentives in primary care, nor do national incentives and policies always have the desired effect. |
| first_indexed | 2025-11-14T19:45:14Z |
| format | Article |
| id | nottingham-41398 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:45:14Z |
| publishDate | 2013 |
| publisher | Wiley |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-413982024-08-15T15:14:36Z https://eprints.nottingham.ac.uk/41398/ Spending by primary care practices-does it show what we expect? James, Marilyn Stokes, Elizabeth Background Over recent years, a number of policies and financial incentives in primary care have been proposed to tackle issues such as deprivation and health outcomes. This article investigates the association between healthcare spending, deprivation and outcomes. It argues that individual practice data are analysed before blanket application and acceptance that one size fits all in a local area. Methods Financial data were analysed alongside key outcome data, including quality and outcomes framework (QOF) indicators for a large urban primary care trust (PCT) in the UK. The PCT had a large population and number of practices, including single-handed practices and an average list size in excess of 5000. The PCT will remain anonymous. Results There was no relationship between primary care investment and the practices' deprivation score. There was a strong statistically significant negative correlation between QOF payments and deprivation, (correlation = −0.46, p < 0.001). There were only weak links between primary care investment and health outcomes. There was no relationship between high emergency spending and health outcome. Conclusions The data presented suggest that one size does not necessarily fit all—in terms of providing the appropriate incentives in primary care, nor do national incentives and policies always have the desired effect. Wiley 2013-11-07 Article PeerReviewed James, Marilyn and Stokes, Elizabeth (2013) Spending by primary care practices-does it show what we expect? International Journal of Health Planning and Management, 29 (3). pp. 244-259. ISSN 1099-1751 primary care policy; investment; outcome; QOF indicators; deprivation http://onlinelibrary.wiley.com/doi/10.1002/hpm.2224/abstract doi:10.1002/hpm.2224 doi:10.1002/hpm.2224 |
| spellingShingle | primary care policy; investment; outcome; QOF indicators; deprivation James, Marilyn Stokes, Elizabeth Spending by primary care practices-does it show what we expect? |
| title | Spending by primary care practices-does it show what we expect? |
| title_full | Spending by primary care practices-does it show what we expect? |
| title_fullStr | Spending by primary care practices-does it show what we expect? |
| title_full_unstemmed | Spending by primary care practices-does it show what we expect? |
| title_short | Spending by primary care practices-does it show what we expect? |
| title_sort | spending by primary care practices-does it show what we expect? |
| topic | primary care policy; investment; outcome; QOF indicators; deprivation |
| url | https://eprints.nottingham.ac.uk/41398/ https://eprints.nottingham.ac.uk/41398/ https://eprints.nottingham.ac.uk/41398/ |