Mark A J Morgan
In 2004, as an attempt to improve and measure the quality of primary care and as part of a new contract with general practitioners, the United Kingdom government introduced a voluntary pay for performance scheme for general practices called the ‘Quality and Outcomes Framework’ (QOF). This provided a potential extra 25% income for GPs and has now been almost universally adopted.
United Kingdom general practitioners
receive payment based on their
performance in multiple clinical
indicators. We set out to apply the same
indicators in an Australian general
practice to benchmark our performance
and to see how much work was
required to obtain the data.
Clinical indicators for the 2008–2009
UK Quality and Outcomes Framework
(QOF) cycle were examined and
achievement levels measured in a large
rural Australian general practice, mainly
by computer searching of the clinical
Outcome measures were obtainable for
79 out of 80 indicators. Manual perusal
of computer records was required for
16 indicators. Data collection takes
approximately 130 hours. The Australian
general practice achieved 66% of
available pay for performance points
compared to the UK average of 97%.
United Kingdom QOF clinical data is
obtainable relatively easily in a well
computerised Australian rural general
practice. The exercise identified
significant areas in which clinical
performance could be improved.
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