Pay for Performance Improves Blood Pressure Control

Gap in service provision between most and least deprived areas in England nearly eliminated
By Jane Parry
HealthDay Reporter

WEDNESDAY, Oct. 29 (HealthDay News) -- The introduction of pay for performance in blood pressure monitoring and control in England has almost eliminated the achievement gap that existed between the country's least and most socially deprived areas, according to a study published online Oct. 29 in the BMJ.

Mark Ashworth, D.M., and colleagues at King's College London analyzed data from almost all of England's primary care practices from 2005 through 2007, during which the Quality and Outcomes Framework, linking financial incentives to performance indicators for all general practitioners in the United Kingdom, was introduced.

In 2005, 82.3 percent of adult patients had an up-to-date blood pressure recording, but by 2007 the proportion had risen to 88.3 percent, the data indicated. The gap between mean blood pressure recording levels in the most and least socially deprived areas of the country narrowed from 1.7 percent to 0.2 percent, the researchers found. Achievement of blood pressure targets in diabetes and coronary heart disease showed a greater improvement in the most socially deprived areas, putting achieved targets almost on par with those in the least socially deprived areas.

"Perhaps the greatest contribution that the quality and outcomes framework has made to changing practice will therefore be the largely unintended consequence of generating more equitable health care," Helen Lester, M.D., of the National Primary Care Research and Development Centre, in Manchester, United Kingdom, says in an accompanying editorial.

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