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Spending by primary care practices—does it show what we expect?
Author(s) -
James Marilyn,
Stokes Elizabeth
Publication year - 2013
Publication title -
the international journal of health planning and management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.672
H-Index - 41
eISSN - 1099-1751
pISSN - 0749-6753
DOI - 10.1002/hpm.2224
Subject(s) - quality and outcomes framework , incentive , payment , investment (military) , primary care , public economics , health care , pay for performance , business , actuarial science , outcome (game theory) , population , demographic economics , medicine , psychology , economics , finance , family medicine , economic growth , environmental health , political science , microeconomics , politics , law
SUMMARY 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 < 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.