Determinants of primary medical care quality measured under the new UK contract: cross sectional study.

Matthew Adam Sutton, G. McLean

    Research output: Contribution to journalArticle

    44 Citations (Scopus)

    Abstract

    Objective To identify factors associated with the quality of primary medical care incentivised under the new UK general medical services contract.

    Design Cross sectional study. 

    Setting NHS Ayrshire and Arran area, Scotland.

    Participants 60 general practices.

    Main outcome measures Quality scores reflecting the total points achieved on the 10 clinical domains and holistic care. Univariate and multivariate regression analyses were used to relate quality scores to measures of population characteristics, urban-rural location, general practitioner characteristics, clinical team size and composition, practice characteristics, and income from other sources.

    Results Deprivation was associated with higher scores. Quality scores increased with the size of the clinical team. Practices with higher income from other sources had lower quality scores. Practices that were accredited, had training status, or contained younger general practitioners had higher quality scores, but these effects were explained by other associated factors. 53% of the variation in quality scores was explained by a multivariate model, which included measures of deprivation, clinical team size and composition, and financial incentives.

    Conclusions Population characteristics showed little association with the quality of primary medical care incentivised under the UK general medical services contract. Larger clinical teams delivered higher quality clinical care, but the nurse-doctor composition of the clinical team did not influence quality Practices that were more likely to respond to financial incentives because of previous behaviour or lower income from other sources recorded higher quality. If generalisable, the results suggest that initiatives to improve primary medical care quality should focus on the structure and resourcing of providers.

    Original languageEnglish
    Pages (from-to)389-390
    Number of pages1
    JournalBritish Medical Journal
    Volume332
    DOIs
    Publication statusPublished - 2006

    Keywords

    • ENGLISH GENERAL-PRACTICE
    • OF-CARE

    Cite this

    Determinants of primary medical care quality measured under the new UK contract: cross sectional study. / Sutton, Matthew Adam; McLean, G.

    In: British Medical Journal, Vol. 332, 2006, p. 389-390.

    Research output: Contribution to journalArticle

    @article{a921b16c23fa42508e0dbb9eb142ff31,
    title = "Determinants of primary medical care quality measured under the new UK contract: cross sectional study.",
    abstract = "Objective To identify factors associated with the quality of primary medical care incentivised under the new UK general medical services contract.Design Cross sectional study. Setting NHS Ayrshire and Arran area, Scotland.Participants 60 general practices.Main outcome measures Quality scores reflecting the total points achieved on the 10 clinical domains and holistic care. Univariate and multivariate regression analyses were used to relate quality scores to measures of population characteristics, urban-rural location, general practitioner characteristics, clinical team size and composition, practice characteristics, and income from other sources.Results Deprivation was associated with higher scores. Quality scores increased with the size of the clinical team. Practices with higher income from other sources had lower quality scores. Practices that were accredited, had training status, or contained younger general practitioners had higher quality scores, but these effects were explained by other associated factors. 53{\%} of the variation in quality scores was explained by a multivariate model, which included measures of deprivation, clinical team size and composition, and financial incentives.Conclusions Population characteristics showed little association with the quality of primary medical care incentivised under the UK general medical services contract. Larger clinical teams delivered higher quality clinical care, but the nurse-doctor composition of the clinical team did not influence quality Practices that were more likely to respond to financial incentives because of previous behaviour or lower income from other sources recorded higher quality. If generalisable, the results suggest that initiatives to improve primary medical care quality should focus on the structure and resourcing of providers.",
    keywords = "ENGLISH GENERAL-PRACTICE, OF-CARE",
    author = "Sutton, {Matthew Adam} and G. McLean",
    year = "2006",
    doi = "10.1136/bmj.38742.554468.55",
    language = "English",
    volume = "332",
    pages = "389--390",
    journal = "BMJ",
    issn = "0959-8146",
    publisher = "BMJ Publishing Group",

    }

    TY - JOUR

    T1 - Determinants of primary medical care quality measured under the new UK contract: cross sectional study.

    AU - Sutton, Matthew Adam

    AU - McLean, G.

    PY - 2006

    Y1 - 2006

    N2 - Objective To identify factors associated with the quality of primary medical care incentivised under the new UK general medical services contract.Design Cross sectional study. Setting NHS Ayrshire and Arran area, Scotland.Participants 60 general practices.Main outcome measures Quality scores reflecting the total points achieved on the 10 clinical domains and holistic care. Univariate and multivariate regression analyses were used to relate quality scores to measures of population characteristics, urban-rural location, general practitioner characteristics, clinical team size and composition, practice characteristics, and income from other sources.Results Deprivation was associated with higher scores. Quality scores increased with the size of the clinical team. Practices with higher income from other sources had lower quality scores. Practices that were accredited, had training status, or contained younger general practitioners had higher quality scores, but these effects were explained by other associated factors. 53% of the variation in quality scores was explained by a multivariate model, which included measures of deprivation, clinical team size and composition, and financial incentives.Conclusions Population characteristics showed little association with the quality of primary medical care incentivised under the UK general medical services contract. Larger clinical teams delivered higher quality clinical care, but the nurse-doctor composition of the clinical team did not influence quality Practices that were more likely to respond to financial incentives because of previous behaviour or lower income from other sources recorded higher quality. If generalisable, the results suggest that initiatives to improve primary medical care quality should focus on the structure and resourcing of providers.

    AB - Objective To identify factors associated with the quality of primary medical care incentivised under the new UK general medical services contract.Design Cross sectional study. Setting NHS Ayrshire and Arran area, Scotland.Participants 60 general practices.Main outcome measures Quality scores reflecting the total points achieved on the 10 clinical domains and holistic care. Univariate and multivariate regression analyses were used to relate quality scores to measures of population characteristics, urban-rural location, general practitioner characteristics, clinical team size and composition, practice characteristics, and income from other sources.Results Deprivation was associated with higher scores. Quality scores increased with the size of the clinical team. Practices with higher income from other sources had lower quality scores. Practices that were accredited, had training status, or contained younger general practitioners had higher quality scores, but these effects were explained by other associated factors. 53% of the variation in quality scores was explained by a multivariate model, which included measures of deprivation, clinical team size and composition, and financial incentives.Conclusions Population characteristics showed little association with the quality of primary medical care incentivised under the UK general medical services contract. Larger clinical teams delivered higher quality clinical care, but the nurse-doctor composition of the clinical team did not influence quality Practices that were more likely to respond to financial incentives because of previous behaviour or lower income from other sources recorded higher quality. If generalisable, the results suggest that initiatives to improve primary medical care quality should focus on the structure and resourcing of providers.

    KW - ENGLISH GENERAL-PRACTICE

    KW - OF-CARE

    U2 - 10.1136/bmj.38742.554468.55

    DO - 10.1136/bmj.38742.554468.55

    M3 - Article

    VL - 332

    SP - 389

    EP - 390

    JO - BMJ

    JF - BMJ

    SN - 0959-8146

    ER -