title: Impact of a pay-for-performance incentive scheme on age, sex, and socioeconomic disparities in diabetes management in UK primary care.
abstract: We examined the impact of a major pay-for-performance initiative introduced into UK primary care in 2004 on disparities in diabetes management between age, sex, and socioeconomic groups in this retrospective cohort study. We used data from the General Practice Research Database enrolling 422 family practices. Existing disparities in risk factor management (HbA1c, blood pressure, cholesterol) narrowed between men and women. Younger patients (<45 years) with diabetes appear to have benefited less from Quality and Outcomes Framework than older patients, resulting in some widening of existing age group disparities. Patients living in affluent and deprived areas appeared to have derived a similar level of benefit from pay for performance.
authors.affiliation: Department of Primary Care and Public Health, Imperial College, London, United Kingdom.
authors.forename: Fiona Louise
authors.initials: FL
authors.lastname: Hamilton
authors.forename: Alex
authors.initials: A
authors.lastname: Bottle
authors.forename: Eszter Panna
authors.initials: EP
authors.lastname: Vamos
authors.forename: Vasa
authors.initials: V
authors.lastname: Curcin
authors.forename: Anthea
authors.initials: A
authors.lastname: Ng
authors.forename: Mariam
authors.initials: M
authors.lastname: Molokhia
authors.forename: Azeem
authors.initials: A
authors.lastname: Majeed
authors.forename: Christopher
authors.initials: C
authors.lastname: Millett
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D011320:Primary Health Care; D012052:Reimbursement, Incentive; D012189:Retrospective Studies; D012308:Risk Management; D012923:Social Class; D006113:United Kingdom; D055815:Young Adult