Cargando…

Relationship between quality of care and choice of clinical computing system: retrospective analysis of family practice performance under the UK's quality and outcomes framework

OBJECTIVES: To investigate the relationship between performance on the UK Quality and Outcomes Framework pay-for-performance scheme and choice of clinical computer system. DESIGN: Retrospective longitudinal study. SETTING: Data for 2007–2008 to 2010–2011, extracted from the clinical computer systems...

Descripción completa

Detalles Bibliográficos
Autores principales: Kontopantelis, Evangelos, Buchan, Iain, Reeves, David, Checkland, Kath, Doran, Tim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3733310/
https://www.ncbi.nlm.nih.gov/pubmed/23913774
http://dx.doi.org/10.1136/bmjopen-2013-003190
_version_ 1782279352155635712
author Kontopantelis, Evangelos
Buchan, Iain
Reeves, David
Checkland, Kath
Doran, Tim
author_facet Kontopantelis, Evangelos
Buchan, Iain
Reeves, David
Checkland, Kath
Doran, Tim
author_sort Kontopantelis, Evangelos
collection PubMed
description OBJECTIVES: To investigate the relationship between performance on the UK Quality and Outcomes Framework pay-for-performance scheme and choice of clinical computer system. DESIGN: Retrospective longitudinal study. SETTING: Data for 2007–2008 to 2010–2011, extracted from the clinical computer systems of general practices in England. PARTICIPANTS: All English practices participating in the pay-for-performance scheme: average 8257 each year, covering over 99% of the English population registered with a general practice. MAIN OUTCOME MEASURES: Levels of achievement on 62 quality-of-care indicators, measured as: reported achievement (levels of care after excluding inappropriate patients); population achievement (levels of care for all patients with the relevant condition) and percentage of available quality points attained. Multilevel mixed effects multiple linear regression models were used to identify population, practice and clinical computing system predictors of achievement. RESULTS: Seven clinical computer systems were consistently active in the study period, collectively holding approximately 99% of the market share. Of all population and practice characteristics assessed, choice of clinical computing system was the strongest predictor of performance across all three outcome measures. Differences between systems were greatest for intermediate outcomes indicators (eg, control of cholesterol levels). CONCLUSIONS: Under the UK's pay-for-performance scheme, differences in practice performance were associated with the choice of clinical computing system. This raises the question of whether particular system characteristics facilitate higher quality of care, better data recording or both. Inconsistencies across systems need to be understood and addressed, and researchers need to be cautious when generalising findings from samples of providers using a single computing system.
format Online
Article
Text
id pubmed-3733310
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-37333102013-08-05 Relationship between quality of care and choice of clinical computing system: retrospective analysis of family practice performance under the UK's quality and outcomes framework Kontopantelis, Evangelos Buchan, Iain Reeves, David Checkland, Kath Doran, Tim BMJ Open General practice / Family practice OBJECTIVES: To investigate the relationship between performance on the UK Quality and Outcomes Framework pay-for-performance scheme and choice of clinical computer system. DESIGN: Retrospective longitudinal study. SETTING: Data for 2007–2008 to 2010–2011, extracted from the clinical computer systems of general practices in England. PARTICIPANTS: All English practices participating in the pay-for-performance scheme: average 8257 each year, covering over 99% of the English population registered with a general practice. MAIN OUTCOME MEASURES: Levels of achievement on 62 quality-of-care indicators, measured as: reported achievement (levels of care after excluding inappropriate patients); population achievement (levels of care for all patients with the relevant condition) and percentage of available quality points attained. Multilevel mixed effects multiple linear regression models were used to identify population, practice and clinical computing system predictors of achievement. RESULTS: Seven clinical computer systems were consistently active in the study period, collectively holding approximately 99% of the market share. Of all population and practice characteristics assessed, choice of clinical computing system was the strongest predictor of performance across all three outcome measures. Differences between systems were greatest for intermediate outcomes indicators (eg, control of cholesterol levels). CONCLUSIONS: Under the UK's pay-for-performance scheme, differences in practice performance were associated with the choice of clinical computing system. This raises the question of whether particular system characteristics facilitate higher quality of care, better data recording or both. Inconsistencies across systems need to be understood and addressed, and researchers need to be cautious when generalising findings from samples of providers using a single computing system. BMJ Publishing Group 2013-08-02 /pmc/articles/PMC3733310/ /pubmed/23913774 http://dx.doi.org/10.1136/bmjopen-2013-003190 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/
spellingShingle General practice / Family practice
Kontopantelis, Evangelos
Buchan, Iain
Reeves, David
Checkland, Kath
Doran, Tim
Relationship between quality of care and choice of clinical computing system: retrospective analysis of family practice performance under the UK's quality and outcomes framework
title Relationship between quality of care and choice of clinical computing system: retrospective analysis of family practice performance under the UK's quality and outcomes framework
title_full Relationship between quality of care and choice of clinical computing system: retrospective analysis of family practice performance under the UK's quality and outcomes framework
title_fullStr Relationship between quality of care and choice of clinical computing system: retrospective analysis of family practice performance under the UK's quality and outcomes framework
title_full_unstemmed Relationship between quality of care and choice of clinical computing system: retrospective analysis of family practice performance under the UK's quality and outcomes framework
title_short Relationship between quality of care and choice of clinical computing system: retrospective analysis of family practice performance under the UK's quality and outcomes framework
title_sort relationship between quality of care and choice of clinical computing system: retrospective analysis of family practice performance under the uk's quality and outcomes framework
topic General practice / Family practice
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3733310/
https://www.ncbi.nlm.nih.gov/pubmed/23913774
http://dx.doi.org/10.1136/bmjopen-2013-003190
work_keys_str_mv AT kontopantelisevangelos relationshipbetweenqualityofcareandchoiceofclinicalcomputingsystemretrospectiveanalysisoffamilypracticeperformanceundertheuksqualityandoutcomesframework
AT buchaniain relationshipbetweenqualityofcareandchoiceofclinicalcomputingsystemretrospectiveanalysisoffamilypracticeperformanceundertheuksqualityandoutcomesframework
AT reevesdavid relationshipbetweenqualityofcareandchoiceofclinicalcomputingsystemretrospectiveanalysisoffamilypracticeperformanceundertheuksqualityandoutcomesframework
AT checklandkath relationshipbetweenqualityofcareandchoiceofclinicalcomputingsystemretrospectiveanalysisoffamilypracticeperformanceundertheuksqualityandoutcomesframework
AT dorantim relationshipbetweenqualityofcareandchoiceofclinicalcomputingsystemretrospectiveanalysisoffamilypracticeperformanceundertheuksqualityandoutcomesframework