Leistungsbezogene Bezahlung für Allgemeinärzte: Das englische Experiment

R. Chenot
2007 ZFA - Zeitschrift für Allgemeinmedizin  
& Background: In 2004 -2006 a quality contract linking a pay-for-performance scheme to health targets for GPs was introduced in the National Health Service. The contract measures practice achievement against a range of evidence-based clinical indicators, covering clinical care for 11 chronic diseases and indicators covering practice organisation and patient experience. Practices score points according to their levels of achievement against these indicators, and practice payments are calculated
more » ... nts are calculated from points achieved. Practice data is collected in a national database, primarily to determine practices payments. Aims: To obtain and analyse information on the quality contract, evaluate the outcomes and disseminate the results. Method: A case study into the implementation and the effects of a pay-for-performance scheme. Analysis of NHS documents, NHS commissioned research and public access-data. Results: Reported achievement for n = 8,486 general practices in England and Scotland in the fi rst year of the new contract was 91.3 % . Thus, the contract increases existing income according to performance. Data on 99.5 % (52.833.584) of registered patients were recorded. Exception reporting was high (15 % and more of patients) in a small number of practices (1.1 % ). Conclusion: Within the clinical domain the quality contract only covers selected conditions and only some aspects of the care for such patients. However it does provide information on a previously unavailable scale, and will provide a baseline against which to measure future levels of improvement in the delivery of care. Practice achievement data represents a potentially valuable source of information for policymakers, healthcare managers or researchers responsible for the planning and delivery of primary care services and resource allocation. Bibliografi e
doi:10.1055/s-2007-977711 fatcat:x7jgq2ahkbc5hjfa6n5bjpsui4