Mind the gap! Evaluation of the performance gap attributable to exception reporting and target thresholds in the new GMS contract: National database analysis
2008

Evaluating the Performance Gap in UK General Practices

Sample size: 8407 publication Evidence: high

Author Information

Author(s): Robert Fleetcroft, Nicholas Steel, Richard Cookson, Amanda Howe

Primary Institution: University of East Anglia

Hypothesis

What is the gap between the financial incentives gained by practices and the percentage of patients receiving indicated care?

Conclusion

Threshold targets and exception reporting significantly reduce the percentage of eligible patients that UK practices need to treat to receive maximum incentive payments.

Supporting Evidence

  • The mean pay-performance gap for the 65 aggregated clinical indicators was 13.3%.
  • 52% of the gap is due to thresholds set below 100%, and 48% is due to exception reporting.
  • The gap exceeded 25% in nine indicators, including significant health interventions.

Takeaway

This study looked at how much money doctors can earn for treating patients and found that they often get paid even when not all patients are treated, which isn't good for health.

Methodology

Analysis of Quality Outcomes Framework data and exception reporting data from 8407 practices in England for the year 2005-6.

Potential Biases

There may be biases in exception reporting rates across different practices.

Limitations

The study relies on data from a single year and may not account for changes in practice behavior over time.

Participant Demographics

Practices in England, with a focus on those participating in the Quality Outcomes Framework.

Digital Object Identifier (DOI)

10.1186/1472-6963-8-131

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