Spending by primary care practices-does it show what we expect?

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

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Abstract

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.

Item Type: Article
Keywords: primary care policy; investment; outcome; QOF indicators; deprivation
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Rehabilitation and Ageing
University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine
Identification Number: 10.1002/hpm.2224
Depositing User: Dziunka, Patricia
Date Deposited: 21 Mar 2017 10:19
Last Modified: 12 Oct 2017 22:27
URI: http://eprints.nottingham.ac.uk/id/eprint/41398

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