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Showing posts from July, 2010

Impact of pay for performance on inequalities in health care

A recent systematic review by Riyadh Alshamsan and colleagues assessed the impact of pay for performance programmes, in particular the Quality & Outcomes Framework in the UK, on inequalities in the quality of health care. There was some evidence that the use of financial incentives reduced inequalities in chronic disease management between socio-economic groups. However, inequalities in chronic disease management between age, sex and ethnic groups persisted after the use of pay for performance incentives. They concluded that inequalities in chronic disease management have often persisted after the introduction of pay for performance programmes such as the Quality and Outcome Framework in the UK. The findings of the paper reinforce the need for pay for performance programmes to be designed to reduce inequalities as well as improve the overall quality of care.

CLAHRC Collaborative Learning and Delivery (CLD) Event

The Summer 2010 NIHR CLAHRC for Northwest London Collaborative Learning and Delivery Event was held at Imperial College on July 1.  The day was attended by over 160 delegates. The focus for the day was patient safety, with an international comparative perspective. We were fortunate in having a number of external speakers at the event, including a delegation of senior academics and clinicians from Taiwan.

The implementation of patient engagement and the quality and safety of the patient journey are key points of importance for the CLAHRC, this was reflected throughout the day in various keynote plenaries, workshops and support sessions. Featured plenary sessions from a range of keynote speakers included: Prof Derek Bell, Programme Director, NIHR CLAHRC for Northwest London; Prof Ken Kuo, Director, Division of Health Policy Research and Development, National Health Research Institutes, Taiwan; Dr Gill Hicks, MBE, Founder, M.A.D. for Peace; and Prof Peter Chang, Dean, Professor and Direc…

Reductions in risk factors for secondary prevention of coronary heart disease

The UK health care system provides universal coverage; hence, equitable health improvement across ethnic groups should be more easily attainable than in fragmented health systems. However, previous studies have shown ethnic health inequalities in cardiovascular disease prevalence, health outcomes and access to interventions and treatment in the UK. In a recent paper published in Family Practice, Joanna Murray and colleagues examined whether policy changes over the past decade in the primary care management of coronary heart disease (CHD), have resulted in improved and more equitable risk factor control among patients. The study was carried out in Wandsworth in South-West London.

They found that over a 10-year period from 1998 to 2007, mean blood pressure among patients with CHD decreased from 140/80 to 133/74 mm Hg, while their mean cholesterol was reduced from 5.2 to 4.3 mmol/l. Reductions in these risk factors occurred among both males and females and across all ethnic groups. The f…

COPD Prevalence Model for England

Diagnosed prevalence and morbidity data underestimate the total burden of chronic obstructive pulmonary disease (COPD) because the disease is usually not diagnosed until it is clinically apparent, and there is considerable variation in reported prevalence. Michael Soljak and colleagues have developed a multivariate model to estimate the expected prevalence of COPD in England, based on the data from the Health Survey for England, which can then used to produce local prevalence estimates. The results of this work were published in the Journal of Public Health. This COPD prevalence model is now available on the APHO Website and contains estimates of prevalence for general practices in England. The model is now being used a tool for COPD case finding.