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Chronic Obstructive Pulmonary Disease (COPD)

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

Type
Disease or Syndrome
ID
PH512
Version ID
1024
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: 58
Code Description Entity type Coding System (OXMIS Read) Category
66YB.00 Chronic obstructive pulmonary disease monitoring res43: copd_kontopantelis_bmjqs2012 Read test
66YD.00 Chronic obstructive pulmonary disease monitoring due res43: copd_kontopantelis_bmjqs2012 Read test
66YI.00 COPD self-management plan given res43: copd_kontopantelis_bmjqs2012 Read test
66YL.00 Chronic obstructive pulmonary disease follow-up res43: copd_kontopantelis_bmjqs2012 Read test
66YL.11 COPD follow-up res43: copd_kontopantelis_bmjqs2012 Read test
66YL.12 COAD follow-up res43: copd_kontopantelis_bmjqs2012 Read test
66YM.00 Chronic obstructive pulmonary disease annual review res43: copd_kontopantelis_bmjqs2012 Read test
66YS.00 Chronic obstructive pulmonary disease monitoring by nurse res43: copd_kontopantelis_bmjqs2012 Read test
66YT.00 Chronic obstructive pulmonary disease monitoring by doctor res43: copd_kontopantelis_bmjqs2012 Read test
66Yd.00 COPD accident and emergency attendance since last visit res43: copd_kontopantelis_bmjqs2012 Read test
66Ye.00 Emergency COPD admission since last appointment res43: copd_kontopantelis_bmjqs2012 Read test
66Yf.00 Number of COPD exacerbations in past year res43: copd_kontopantelis_bmjqs2012 Read test
66Yg.00 Chronic obstructive pulmonary disease disturbs sleep res43: copd_kontopantelis_bmjqs2012 Read test
66Yh.00 Chronic obstructive pulmonary disease does not disturb sleep res43: copd_kontopantelis_bmjqs2012 Read test
66Yi.00 Multiple COPD emergency hospital admissions res43: copd_kontopantelis_bmjqs2012 Read test
8H2R.00 Admit COPD emergency res43: copd_kontopantelis_bmjqs2012 Read test
H3...00 Chronic obstructive pulmonary disease res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H31..00 Chronic bronchitis res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H310.00 Simple chronic bronchitis res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H310000 Chronic catarrhal bronchitis res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H310z00 Simple chronic bronchitis NOS res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H311.00 Mucopurulent chronic bronchitis res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H311000 Purulent chronic bronchitis res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H311100 Fetid chronic bronchitis res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H311z00 Mucopurulent chronic bronchitis NOS res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H312.00 Obstructive chronic bronchitis res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H312000 Chronic asthmatic bronchitis res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H312011 Chronic wheezy bronchitis res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H312100 Emphysematous bronchitis res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H312200 Acute exacerbation of chronic obstructive airways disease res43: copd_kontopantelis_bmjqs2012 Read symptom
H312300 Bronchiolitis obliterans res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H312z00 Obstructive chronic bronchitis NOS res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H313.00 Mixed simple and mucopurulent chronic bronchitis res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H31y.00 Other chronic bronchitis res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H31y100 Chronic tracheobronchitis res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H31yz00 Other chronic bronchitis NOS res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H31z.00 Chronic bronchitis NOS res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H32..00 Emphysema res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H320.00 Chronic bullous emphysema res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H320000 Segmental bullous emphysema res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H320100 Zonal bullous emphysema res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H320200 Giant bullous emphysema res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H320300 Bullous emphysema with collapse res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H320z00 Chronic bullous emphysema NOS res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H321.00 Panlobular emphysema res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H322.00 Centrilobular emphysema res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H32y.00 Other emphysema res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H32y000 Acute vesicular emphysema res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H32y100 Atrophic (senile) emphysema res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H32y111 Acute interstitial emphysema res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H32y200 MacLeod's unilateral emphysema res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H32yz00 Other emphysema NOS res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H32z.00 Emphysema NOS res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H36..00 Mild chronic obstructive pulmonary disease res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H37..00 Moderate chronic obstructive pulmonary disease res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H38..00 Severe chronic obstructive pulmonary disease res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H3y..11 Other specified chronic obstructive pulmonary disease res43: copd_kontopantelis_bmjqs2012 Read diagnostic
H3z..11 Chronic obstructive pulmonary disease NOS res43: copd_kontopantelis_bmjqs2012 Read diagnostic
Rows: 8
Code Description Entity type Coding System (OXMIS Read) Category
491 CHRONIC BRONCHITIS res43: copd_kontopantelis_bmjqs2012 OXMIS diagnostic
491 E CHRONIC BRONCHITIS WITH EMPHYSEMA res43: copd_kontopantelis_bmjqs2012 OXMIS diagnostic
492 EMPHYSEMA PULMONARY res43: copd_kontopantelis_bmjqs2012 OXMIS diagnostic
492 AC EMPHYSEMA APICAL BULLAE res43: copd_kontopantelis_bmjqs2012 OXMIS diagnostic
5199G OBSTRUCTIVE AIRWAYS DISEASE CHRONIC res43: copd_kontopantelis_bmjqs2012 OXMIS diagnostic
5199GE EXACERBATION COAD res43: copd_kontopantelis_bmjqs2012 OXMIS symptom
5199GL COLD (CHRONIC OBSTRUCTIVE LUNG DISEASE) res43: copd_kontopantelis_bmjqs2012 OXMIS diagnostic
5199GP COPD (CHRONIC OBSTRUCTIVE PULMONARY DISE res43: copd_kontopantelis_bmjqs2012 OXMIS diagnostic

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH512/version/1024/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH512/version/1024/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('PH512', '1024', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH512/version/1024/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH512/version/1024/export/codes/?format=json
CSV site_root/phenotypes/PH512/version/1024/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('PH512', '1024', api_client=client)

Version History

Version
ID
Name Owner Publish date
1024 Chronic Obstructive Pulmonary Disease (COPD) ieuan.scanlon 2021-10-06 currently shown

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