title: Which quality and outcomes framework (QOF) clinical indicators are applicable for British Forces Germany Health Service (BFG HS) primary care?
abstract: OBJECTIVE
  To determine which QOF clinical indicators are applicable for BFG HS primary care.
  
  
  METHODS
  In depth cross-sectional survey of BFG HS general practitioners. Participants were requested to assess all 19 QOF clinical domains (80 clinical indicators) and to indicate to what extent these were applicable for BFG HS (Likert scale 1-5). Response rate was documented. Cronbach's alpha reliability was calculated and a comparison of the mean responses of training and non-training practices was made.
  
  
  RESULTS
  The response rate was 80% (28/35). Cronbach's alpha was 0.91.The mean score for both training practices and non-training practices was 3.9. Based on the mean score the applicable indicators were (in descending order): Hypothyroidism (mean 4.6, 95% confidence interval 4.5-4.8), Hypertension (4.6, 4.5-4.8), Asthma (4.3, 4.2-4.5), Diabetes mellitus (4.3, 4.2-4.3), Obesity (4.1, 4.0-4.2), Chronic Heart Disease (4.1, 3.9-4.2), Epilepsy (4.0, 3.9-4.2) and Smoking (4.0, 3.7-4.2). Problematic were (descending means): Cancer (3.9, 3.6-4.2), Stroke and TIA (3.8, 3.7-4.0), Atrial fibrillation (3.6, 3.3-3.8), Learning disabilities (3.5, 3.1- 4.0), Chronic kidney disease (3.5, 3.3-3.8), Chronic Obstructive Pulmonary Disease (3.5, 3.3-3.7), Mental health (3.5, 3.3-3.6), Heart failure (3.4, 3.1-3.7), Depression (3.2, 2.8-3.5) and Palliative care (3.2, 2.7-3.6). Not applicable was Dementia (2.4, 2.0-2.8).
  
  
  CONCLUSIONS
  This study shows that several but not all QOF clinical indicators are applicable in BFG HS. Therefore QOF cannot be directly transferred to BFH HS and an adapted quality framework is required.
authors.affiliation: Medical Centre Gütersloh, Princess Royal Barracks. rickvandenheuvel@doctors.org.uk
authors.forename: H G J
authors.initials: HG
authors.lastname: van den Heuvel
authors.forename: R G
authors.initials: RG
authors.lastname: Simpson
mesh_terms: D002908:Chronic Disease; D002983:Clinical Competence / Q000592:standards / Q000706:statistics & numerical data; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005858:Germany; D006801:Humans; D008887:Military Medicine / Q000592:standards*; D008889:Military Personnel / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care / Q000592:standards* / Q000706:statistics & numerical data; D019984:Quality Indicators, Health Care / Q000592:standards*; D006113:United Kingdom