Evaluating Equity in the Quality and Outcomes Framework
Author Information
Author(s): Boeckxstaens Pauline, Smedt Delphine De, Maeseneer Jan De, Annemans Lieven, Willems Sara
Primary Institution: Ghent University
Hypothesis
How has the introduction of the Quality and Outcomes Framework (QOF) affected equity in healthcare access and treatment outcomes in the UK?
Conclusion
The introduction of QOF has generally improved healthcare quality, but benefits vary among different patient groups, particularly by age and gender.
Supporting Evidence
- None of the publications assessed equity in access to health care.
- Overall quality scores generally improved after QOF implementation.
- Improvements in care quality varied significantly among different patient groups.
- Older patients and males generally benefited more from QOF.
- Small but significant residual differences in care quality were observed favoring less deprived groups.
Takeaway
This study looks at how a payment system for doctors affects fairness in healthcare. It found that while care has improved, some groups, like older people and men, benefit more than others.
Methodology
A systematic review of 317 studies was conducted, with 27 selected for analysis based on their relevance to equity in the QOF.
Potential Biases
Potential biases exist due to the focus on practice-level data rather than individual patient data, which may obscure true disparities.
Limitations
The studies primarily used practice-level data, which may not accurately reflect individual patient experiences and could lead to ecological fallacy.
Participant Demographics
The studies included various demographics, focusing on socio-economic status, ethnicity, age, and gender differences.
Digital Object Identifier (DOI)
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