[ { "phenotype_id": "PH511", "phenotype_version_id": 1022, "name": "Chronic Kidney Disease (CKD)", "definition": "Background:\n\nThe UK’s Quality and Outcomes Framework (QOF) was introduced in 2004/5, linking remuneration for general practices to recorded quality of care for chronic conditions, including diabetes mellitus. We assessed the effect of the incentives on recorded quality of care for diabetes patients and its variation by patient and practice characteristics.\n\n\nMethods: \n\nUsing the General Practice Research Database we selected a stratified sample of 148 English general practices in England, contributing data from 2000/1 to 2006/7, and obtained a random sample of 653 500 patients in which 23 920 diabetes patients identified. We quantified annually recorded quality of care at the patient-level, as measured by the 17 QOF diabetes indicators, in a composite score and analysed it longitudinally using an Interrupted Time Series design.\n\n\nResults:\n\nRecorded quality of care improved for all subgroups in the pre-incentive period. In the first year of the incentives, composite quality improved over-and-above this pre-incentive trend by 14.2% (13.7–14.6%). By the third year the improvement above trend was smaller, but still statistically significant, at 7.3% (6.7–8.0%). After 3 years of the incentives, recorded levels of care varied significantly for patient gender, age, years of previous care, number of co-morbid conditions and practice diabetes prevalence.\n\n\nConclusions:\n\nThe introduction of financial incentives was associated with improvements in the recorded quality of diabetes care in the first year. These improvements included some measures of disease control, but most captured only documentation of recommended aspects of clinical assessment, not patient management or outcomes of care. Improvements in subsequent years were more modest. Variation in care between population groups diminished under the incentives, but remained substantial in some cases.\n\n\n\n\n\n\n\n\n", "implementation": "", "publications": [ { "doi": null, "details": "Evangelos Kontopantelis, David Reeves, Jose M Valderas, Stephen Campbell, Tim Doran, Recorded quality of primary care for patients with diabetes in England before and after the introduction of a financial incentive scheme a longitudinal observational study. BMJ Qual Saf, 22, 53-64, 2013." } ], "validation": "", "citation_requirements": "", "created": "2021-10-06T16:23:09.296961Z", "author": "Evengelos Kontopantelis, David Reeves, Jose M Valderas, Stephen Campbell, Tim Doran", "collections": [ { "name": "ClinicalCodes Repository", "value": 25 }, { "name": "Phenotype Library", "value": 18 } ], "tags": null, "organisation": null, "world_access": 1, "updated": "2021-10-06T16:23:09.296991Z", "sex": [ { "name": "Both", "value": "3" } ], "type": [ { "name": "Disease or syndrome", "value": "2" } ], "ontology": null, "phenoflowid": "", "data_sources": [ { "name": "CPRD GOLD", "value": 5, "uid": "a29feafa-7bdd-44e9-b977-c9d26425e67f", "url": "https://healthdatagateway.org/en/dataset/694", "datasource_id": 694 } ], "coding_system": [ { "name": "Read codes v2", "value": 5 }, { "name": "OXMIS codes", "value": 15 } ], "event_date_range": "01/01/2000 - 31/12/2007", "concept_information": [ { "concept_id": 1882, "concept_version_id": 4902, "concept_name": "Chronic Kidney Disease (CKD) - Primary Care", "coding_system": { "id": 5, "name": "Read codes v2", "description": "Read codes v2" }, "phenotype_id": "PH511", "phenotype_version_id": 1022, "phenotype_name": "Chronic Kidney Disease (CKD)", "code_attribute_header": [ "Entity type", "Coding System (OXMIS Read)", "Category" ], "codes": [ { "code": "1Z12.00", "description": "Chronic kidney disease stage 3", "attributes": { "Entity type": "res43: ckd_kontopantelis_bmjqs2012", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "1Z13.00", "description": "Chronic kidney disease stage 4", "attributes": { "Entity type": "res43: ckd_kontopantelis_bmjqs2012", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "1Z14.00", "description": "Chronic kidney disease stage 5", "attributes": { "Entity type": "res43: ckd_kontopantelis_bmjqs2012", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "D215000", "description": "Anaemia secondary to chronic renal failure", "attributes": { "Entity type": "res43: ckd_kontopantelis_bmjqs2012", "Coding System (OXMIS Read)": "Read", "Category": "symptom" } }, { "code": "K05..00", "description": "Chronic renal failure", "attributes": { "Entity type": "res43: ckd_kontopantelis_bmjqs2012", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } }, { "code": "Kyu2100", "description": "[X]Other chronic renal failure", "attributes": { "Entity type": "res43: ckd_kontopantelis_bmjqs2012", "Coding System (OXMIS Read)": "Read", "Category": "diagnostic" } } ] }, { "concept_id": 1883, "concept_version_id": 4904, "concept_name": "Chronic Kidney Disease (CKD) - Primary Care", "coding_system": { "id": 15, "name": "OXMIS codes", "description": "OXMIS codes" }, "phenotype_id": "PH511", "phenotype_version_id": 1022, "phenotype_name": "Chronic Kidney Disease (CKD)", "code_attribute_header": [ "Entity type", "Coding System (OXMIS Read)", "Category" ], "codes": [ { "code": "5932EC", "description": "CHRONIC RENAL FAILURE", "attributes": { "Entity type": "res43: ckd_kontopantelis_bmjqs2012", "Coding System (OXMIS Read)": "OXMIS", "Category": "diagnostic" } } ] } ], "status": 2, "doi": "https://doi.org/10.48533/7gyp-hk02", "is_deleted": null, "publish_status": 2, "owner": "ieuan.scanlon", "template": { "id": 1, "name": "Clinical-Coded Phenotype", "description": "Phenotype definitions that are based on lists of clinical codes, or algorithms using clinical codes.", "version_id": 1 }, "versions": [ { "version_id": 1022, "version_name": "Chronic Kidney Disease (CKD)", "version_date": "2021-10-06T16:23:09.318671Z", "is_published": true, "is_latest": true } ] } ]