A study by the Centre for Health Economics (CHE) investigated whether incentives offered to GPs to provide annual reviews for patients with dementia, under the Quality and Outcomes Framework (QOF), actually reduce the risk of admissions to care homes. It is generally assumed that annual health checks should help to reduce or delay care home admissions, by supporting dementia patients to live independently, and by addressing carers’ support needs.
The “null hypothesis”, had one been stated, would have been along the following lines:
“The QOF annual dementia review is not associated with a reduced likelihood of care home placement”.
The “null hypothesis” was upheld.
The report includes speculation concerning the various influences or confounding factors which might explain away these findings. The interface between primary care and long-term care is complex, the authors conclude.
Kasteridis, P. Liu, D. [and] Mason, A. [et al] (2019). The impact of primary care incentive schemes on care home placements for people with dementia. York: Centre for Health Economics (University of York), May 2019. CHE Research Paper 164.
Questions About the Usefulness of Quality and Outcomes Framework (QOF) Payments for LTCs More Generally
A broader, loosely related, systematic review of QOF payments as a means of motivating high-quality primary care for people with other long-term conditions:
Forbes, LJ. Marchand, C. [and] Doran, T. [et al] (2017). The role of the Quality and Outcomes Framework in the care of long-term conditions: a systematic review. British Journal of General Practice. November 2017; 67(664): e775-e784.