Skip to main content

Research Repository

Advanced Search

The role of cost-effectiveness analysis in the development of indicators to support incentive-based behaviour in primary care in England

Qureshi, Nadeem; Weng, Stephen; Hex, Nick

Authors

Stephen Weng

Nick Hex



Abstract

In England, general practitioners are incentivized through a national pay-for-performance scheme to adopt evidence-based quality improvement initiatives using a portfolio of Quality and Outcomes Framework (QOF) indicators. We describe the development of the methods used to assess the cost-effectiveness of these pay-for-performance indicators and how they have contributed to the development of new indicators. Prior to analysis of new potential indicators, an economic subgroup of the National Institute for Health and Care Excellence (NICE) Indicator Advisory Committee is formed to assess evidence on the cost-effectiveness of potential indicators in terms of the health benefits gained, compared to the cost of the intervention and the cost of the incentive. The expert subgroup is convened to reach consensus on the amounts that could potentially be paid to general practices for achieving new indicators. Indicators are also piloted in selected general practices and evidence gathered about their practical implementation. The methods used to assess economic viability of new pilot indicators represent a pragmatic and effective way of providing information to inform recommendations. Current policy to reduce QOF funding could shift the focus from national (QOF) to local schemes, with economic appraisal remaining central.

Citation

Qureshi, N., Weng, S., & Hex, N. (in press). The role of cost-effectiveness analysis in the development of indicators to support incentive-based behaviour in primary care in England. Journal of Health Services Research and Policy, https://doi.org/10.1177/1355819616650912

Journal Article Type Article
Acceptance Date Apr 12, 2016
Online Publication Date May 20, 2016
Deposit Date Jun 29, 2016
Publicly Available Date Jun 29, 2016
Journal Journal of Health Services Research & Policy
Print ISSN 1355-8196
Electronic ISSN 1758-1060
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
DOI https://doi.org/10.1177/1355819616650912
Keywords cost-effectiveness; pay-for-performance; primary care
Public URL http://eprints.nottingham.ac.uk/id/eprint/34460
Publisher URL http://hsr.sagepub.com/content/early/2016/05/20/1355819616650912
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf

Files

Qureshi_JHSRP_Revised_v2_1 March 2016.pdf (563 Kb)
PDF

Copyright Statement
Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf





You might also like



Downloadable Citations