Print

Coronary Heart Disease (CHD)

Evengelos Kontopantelis, David Reeves, Jose M Valderas, Stephen Campbell, Tim Doran

Type
Disease or Syndrome
ID
PH506
Version ID
1012
Data Sources
Valid event data range
01/01/2000 - 31/12/2007
Sex
Female, Male
Agreement Date
2012-08-22
Coding system
Read codes v2 OXMIS codes
Tags /Collections
ClinicalCodes Repository Phenotype Library

Definition

Background:

The 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.

Methods:

Using 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.

Results:

Recorded 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.

Conclusions:

The 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.

Publications

  • 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.

Clinical Code List

Rows: 129
Code Description Entity type Coding System (OXMIS Read) Category
14AJ.00 H/O: Angina in last year res43: chd_kontopantelis_bmjqs2012 Read diagnostic
662K.00 Angina control res43: chd_kontopantelis_bmjqs2012 Read test
662K000 Angina control - good res43: chd_kontopantelis_bmjqs2012 Read test
662K100 Angina control - poor res43: chd_kontopantelis_bmjqs2012 Read test
662K200 Angina control - improving res43: chd_kontopantelis_bmjqs2012 Read test
662K300 Angina control - worsening res43: chd_kontopantelis_bmjqs2012 Read test
662Kz00 Angina control NOS res43: chd_kontopantelis_bmjqs2012 Read test
662N.00 CHD monitoring res43: chd_kontopantelis_bmjqs2012 Read test
6A2..00 Coronary heart disease annual review res43: chd_kontopantelis_bmjqs2012 Read test
6A4..00 Coronary heart disease review res43: chd_kontopantelis_bmjqs2012 Read test
8B27.00 Antianginal therapy res43: chd_kontopantelis_bmjqs2012 Read drug
8B3k.00 Coronary heart disease medication review res43: chd_kontopantelis_bmjqs2012 Read drug
8B63.11 Aspirin prophylaxis - IHD res43: chd_kontopantelis_bmjqs2012 Read drug
8CR6.00 Coronary heart disease risk clinical management plan res43: chd_kontopantelis_bmjqs2012 Read test
9Ob0.00 Attends coronary heart disease monitoring res43: chd_kontopantelis_bmjqs2012 Read test
9Ob8.00 Coronary heart disease monitoring check done res43: chd_kontopantelis_bmjqs2012 Read test
G3...00 Ischaemic heart disease res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G3...11 Arteriosclerotic heart disease res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G3...12 Atherosclerotic heart disease res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G3...13 IHD - Ischaemic heart disease res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G30..00 Acute myocardial infarction res43: chd_kontopantelis_bmjqs2012 Read symptom
G30..11 Attack - heart res43: chd_kontopantelis_bmjqs2012 Read symptom
G30..12 Coronary thrombosis res43: chd_kontopantelis_bmjqs2012 Read symptom
G30..13 Cardiac rupture following myocardial infarction (MI) res43: chd_kontopantelis_bmjqs2012 Read symptom
G30..14 Heart attack res43: chd_kontopantelis_bmjqs2012 Read symptom
G30..15 MI - acute myocardial infarction res43: chd_kontopantelis_bmjqs2012 Read symptom
G30..16 Thrombosis - coronary res43: chd_kontopantelis_bmjqs2012 Read symptom
G30..17 Silent myocardial infarction res43: chd_kontopantelis_bmjqs2012 Read symptom
G300.00 Acute anterolateral infarction res43: chd_kontopantelis_bmjqs2012 Read symptom
G301.00 Other specified anterior myocardial infarction res43: chd_kontopantelis_bmjqs2012 Read symptom
G301000 Acute anteroapical infarction res43: chd_kontopantelis_bmjqs2012 Read symptom
G301100 Acute anteroseptal infarction res43: chd_kontopantelis_bmjqs2012 Read symptom
G301z00 Anterior myocardial infarction NOS res43: chd_kontopantelis_bmjqs2012 Read symptom
G302.00 Acute inferolateral infarction res43: chd_kontopantelis_bmjqs2012 Read symptom
G303.00 Acute inferoposterior infarction res43: chd_kontopantelis_bmjqs2012 Read symptom
G304.00 Posterior myocardial infarction NOS res43: chd_kontopantelis_bmjqs2012 Read symptom
G305.00 Lateral myocardial infarction NOS res43: chd_kontopantelis_bmjqs2012 Read symptom
G306.00 True posterior myocardial infarction res43: chd_kontopantelis_bmjqs2012 Read symptom
G307.00 Acute subendocardial infarction res43: chd_kontopantelis_bmjqs2012 Read symptom
G307000 Acute non-Q wave infarction res43: chd_kontopantelis_bmjqs2012 Read symptom
G307100 Acute non-ST segment elevation myocardial infarction res43: chd_kontopantelis_bmjqs2012 Read symptom
G308.00 Inferior myocardial infarction NOS res43: chd_kontopantelis_bmjqs2012 Read symptom
G309.00 Acute Q-wave infarct res43: chd_kontopantelis_bmjqs2012 Read symptom
G30A.00 Mural thrombosis res43: chd_kontopantelis_bmjqs2012 Read symptom
G30B.00 Acute posterolateral myocardial infarction res43: chd_kontopantelis_bmjqs2012 Read symptom
G30X.00 Acute transmural myocardial infarction of unspecif site res43: chd_kontopantelis_bmjqs2012 Read symptom
G30X000 Acute ST segment elevation myocardial infarction res43: chd_kontopantelis_bmjqs2012 Read symptom
G30y.00 Other acute myocardial infarction res43: chd_kontopantelis_bmjqs2012 Read symptom
G30y000 Acute atrial infarction res43: chd_kontopantelis_bmjqs2012 Read symptom
G30y100 Acute papillary muscle infarction res43: chd_kontopantelis_bmjqs2012 Read symptom
G30y200 Acute septal infarction res43: chd_kontopantelis_bmjqs2012 Read symptom
G30yz00 Other acute myocardial infarction NOS res43: chd_kontopantelis_bmjqs2012 Read symptom
G30z.00 Acute myocardial infarction NOS res43: chd_kontopantelis_bmjqs2012 Read symptom
G31..00 Other acute and subacute ischaemic heart disease res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G310.00 Postmyocardial infarction syndrome res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G310.11 Dressler's syndrome res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G311.00 Preinfarction syndrome res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G311.11 Crescendo angina res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G311.12 Impending infarction res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G311.13 Unstable angina res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G311.14 Angina at rest res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G311000 Myocardial infarction aborted res43: chd_kontopantelis_bmjqs2012 Read symptom
G311011 MI - myocardial infarction aborted res43: chd_kontopantelis_bmjqs2012 Read symptom
G311100 Unstable angina res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G311200 Angina at rest res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G311300 Refractory angina res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G311400 Worsening angina res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G311500 Acute coronary syndrome res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G311z00 Preinfarction syndrome NOS res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G312.00 Coronary thrombosis not resulting in myocardial infarction res43: chd_kontopantelis_bmjqs2012 Read symptom
G31y.00 Other acute and subacute ischaemic heart disease res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G31y000 Acute coronary insufficiency res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G31y100 Microinfarction of heart res43: chd_kontopantelis_bmjqs2012 Read symptom
G31y200 Subendocardial ischaemia res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G31y300 Transient myocardial ischaemia res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G31yz00 Other acute and subacute ischaemic heart disease NOS res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G32..00 Old myocardial infarction res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G32..11 Healed myocardial infarction res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G32..12 Personal history of myocardial infarction res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G33..00 Angina pectoris res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G330.00 Angina decubitus res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G330000 Nocturnal angina res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G330z00 Angina decubitus NOS res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G331.00 Prinzmetal's angina res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G331.11 Variant angina pectoris res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G332.00 Coronary artery spasm res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G33z.00 Angina pectoris NOS res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G33z000 Status anginosus res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G33z100 Stenocardia res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G33z200 Syncope anginosa res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G33z300 Angina on effort res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G33z400 Ischaemic chest pain res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G33z500 Post infarct angina res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G33z600 New onset angina res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G33z700 Stable angina res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G33zz00 Angina pectoris NOS res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G34..00 Other chronic ischaemic heart disease res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G340.00 Coronary atherosclerosis res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G340.11 Triple vessel disease of the heart res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G340.12 Coronary artery disease res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G340000 Single coronary vessel disease res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G340100 Double coronary vessel disease res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G342.00 Atherosclerotic cardiovascular disease res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G343.00 Ischaemic cardiomyopathy res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G344.00 Silent myocardial ischaemia res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G34y.00 Other specified chronic ischaemic heart disease res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G34y000 Chronic coronary insufficiency res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G34y100 Chronic myocardial ischaemia res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G34yz00 Other specified chronic ischaemic heart disease NOS res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G34z.00 Other chronic ischaemic heart disease NOS res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G34z000 Asymptomatic coronary heart disease res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G35..00 Subsequent myocardial infarction res43: chd_kontopantelis_bmjqs2012 Read symptom
G350.00 Subsequent myocardial infarction of anterior wall res43: chd_kontopantelis_bmjqs2012 Read symptom
G351.00 Subsequent myocardial infarction of inferior wall res43: chd_kontopantelis_bmjqs2012 Read symptom
G353.00 Subsequent myocardial infarction of other sites res43: chd_kontopantelis_bmjqs2012 Read symptom
G35X.00 Subsequent myocardial infarction of unspecified site res43: chd_kontopantelis_bmjqs2012 Read symptom
G36..00 Certain current complication follow acute myocardial infarct res43: chd_kontopantelis_bmjqs2012 Read symptom
G360.00 Haemopericardium/current comp folow acut myocard infarct res43: chd_kontopantelis_bmjqs2012 Read symptom
G361.00 Atrial septal defect/curr comp folow acut myocardal infarct res43: chd_kontopantelis_bmjqs2012 Read symptom
G362.00 Ventric septal defect/curr comp fol acut myocardal infarctn res43: chd_kontopantelis_bmjqs2012 Read symptom
G363.00 Ruptur cardiac wall w'out haemopericard/cur comp fol ac MI res43: chd_kontopantelis_bmjqs2012 Read symptom
G364.00 Ruptur chordae tendinae/curr comp fol acute myocard infarct res43: chd_kontopantelis_bmjqs2012 Read symptom
G365.00 Rupture papillary muscle/curr comp fol acute myocard infarct res43: chd_kontopantelis_bmjqs2012 Read symptom
G366.00 Thrombosis atrium,auric append&vent/curr comp foll acute MI res43: chd_kontopantelis_bmjqs2012 Read symptom
G3y..00 Other specified ischaemic heart disease res43: chd_kontopantelis_bmjqs2012 Read diagnostic
G3z..00 Ischaemic heart disease NOS res43: chd_kontopantelis_bmjqs2012 Read diagnostic
Gyu3.00 [X]Ischaemic heart diseases res43: chd_kontopantelis_bmjqs2012 Read diagnostic
Gyu3200 [X]Other forms of acute ischaemic heart disease res43: chd_kontopantelis_bmjqs2012 Read diagnostic
Gyu3300 [X]Other forms of chronic ischaemic heart disease res43: chd_kontopantelis_bmjqs2012 Read diagnostic
Rows: 18
Code Description Entity type Coding System (OXMIS Read) Category
4119B ISCHAEMIC HEART DISEASE SUBACUTE res43: chd_kontopantelis_bmjqs2012 OXMIS diagnostic
4120A ISCHAEMIC HEART DISEASE HYPERTENSIVE res43: chd_kontopantelis_bmjqs2012 OXMIS diagnostic
4129 ISCHAEMIC HEART DISEASE CHRONIC res43: chd_kontopantelis_bmjqs2012 OXMIS diagnostic
4129AN ISCHAEMIC HEART DISEASE res43: chd_kontopantelis_bmjqs2012 OXMIS diagnostic
4129N ISCHAEMIC HEART DISEASE ASYMPTOMATIC res43: chd_kontopantelis_bmjqs2012 OXMIS diagnostic
4130 ANGINA PECTORIS WITH HYPERTENSION res43: chd_kontopantelis_bmjqs2012 OXMIS diagnostic
4130E ANGINA EFFORT WITH HYPERTENSION res43: chd_kontopantelis_bmjqs2012 OXMIS diagnostic
4139 ANGINA PECTORIS res43: chd_kontopantelis_bmjqs2012 OXMIS diagnostic
4139AA ANGINA ATTACK res43: chd_kontopantelis_bmjqs2012 OXMIS diagnostic
4139AT ANGINA ATYPICAL res43: chd_kontopantelis_bmjqs2012 OXMIS diagnostic
4139C CARDIAC ANGINA res43: chd_kontopantelis_bmjqs2012 OXMIS diagnostic
4139CO ANGINA CRESCENDO res43: chd_kontopantelis_bmjqs2012 OXMIS diagnostic
4139E ANGINA EFFORT res43: chd_kontopantelis_bmjqs2012 OXMIS diagnostic
4139M SYNDROME ANGINAL res43: chd_kontopantelis_bmjqs2012 OXMIS diagnostic
4139N ANGINA res43: chd_kontopantelis_bmjqs2012 OXMIS diagnostic
4139PA ANGINA INVERSA res43: chd_kontopantelis_bmjqs2012 OXMIS diagnostic
4139U UNSTABLE ANGINA res43: chd_kontopantelis_bmjqs2012 OXMIS diagnostic
4149 ASYMPTOMATIC ISCHAEMIC HEART DISEASE res43: chd_kontopantelis_bmjqs2012 OXMIS diagnostic

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH506/version/1012/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH506/version/1012/detail/?format=json
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get details of phenotype

details = get_phenotype_detail_by_version('PH506', '1012', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH506/version/1012/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH506/version/1012/export/codes/?format=json
CSV site_root/phenotypes/PH506/version/1012/export/codes/
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get codelists of phenotype

codelists = get_phenotype_code_list('PH506', '1012', api_client=client)

Version History

Version
ID
Name Owner Publish date
1012 Coronary Heart Disease (CHD) ieuan.scanlon 2021-10-06 currently shown

Export - export all codes into a csv file/JSON/XML for the current phenotype version.

Print - Print page.