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Spending by primary care practices-does it show what we expect?

James, Marilyn; Stokes, Elizabeth

Authors

Marilyn James marilyn.james@nottingham.ac.uk

Elizabeth Stokes



Abstract

Background
Over recent years, a number of policies and financial incentives in primary care have been proposed to tackle issues such as deprivation and health outcomes. This article investigates the association between healthcare spending, deprivation and outcomes. It argues that individual practice data are analysed before blanket application and acceptance that one size fits all in a local area.

Methods
Financial data were analysed alongside key outcome data, including quality and outcomes framework (QOF) indicators for a large urban primary care trust (PCT) in the UK. The PCT had a large population and number of practices, including single-handed practices and an average list size in excess of 5000. The PCT will remain anonymous.

Results
There was no relationship between primary care investment and the practices' deprivation score. There was a strong statistically significant negative correlation between QOF payments and deprivation, (correlation = −0.46, p less than 0.001). There were only weak links between primary care investment and health outcomes. There was no relationship between high emergency spending and health outcome.

Conclusions
The data presented suggest that one size does not necessarily fit all—in terms of providing the appropriate incentives in primary care, nor do national incentives and policies always have the desired effect. © 2013 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd.

Journal Article Type Article
Publication Date 2014-07
Journal The International Journal of Health Planning and Management
Print ISSN 0749-6753
Electronic ISSN 1099-1751
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 29
Issue 3
Pages 244-259
APA6 Citation James, M., & Stokes, E. (2014). Spending by primary care practices-does it show what we expect?. International Journal of Health Planning and Management, 29(3), 244-259. https://doi.org/10.1002/hpm.2224
DOI https://doi.org/10.1002/hpm.2224
Keywords primary care policy; investment; outcome; QOF indicators; deprivation
Publisher URL http://onlinelibrary.wiley.com/doi/10.1002/hpm.2224/abstract
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc-nd/4.0

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc-nd/4.0





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