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. 2009 Mar;102(3):103-7.
doi: 10.1258/jrsm.2009.080389.

Impact of pay for performance on quality of chronic disease management by social class group in England

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Free PMC article

Impact of pay for performance on quality of chronic disease management by social class group in England

Danielle Crawley et al. J R Soc Med. 2009 Mar.
Free PMC article

Abstract

Objective: To examine associations between social class and achievement of selected national audit targets for coronary heart disease (CHD), diabetes and hypertension in England before and after the introduction of a major pay for performance programme in 2004.

Design: Secondary analysis of 2003 and 2006 national survey data for respondents with CHD and diabetes and hypertension.

Setting: England.

Main outcome measure: Achievement of national audit targets for blood pressure, blood glucose and cholesterol control.

Results: There were no significant differences in achievement of blood pressure targets in individuals from manual and non-manual occupational groups with diabetes (2003: 65.9% v 60.3%, 2006: 67.6% v 69.7%) or hypertension (2003: 66.2% v 66.2%, 2006: 72.8% v 71.9%) before or after the introduction of pay for performance. Achievement of the cholesterol target was also similar in individuals from manual and non-manual groups with diabetes (2003: 52.5% v 46.6%, 2006: 68.7% v 70.5%) or CHD (2003: 54.3% v 53.3%, 2006: 68.6% v 71.3%). Differences in achievement of the blood pressure target in CHD [75.8% v 84.5%; AOR 0.44 (0.21-0.90)] were evident between manual and non-manual occupational groups after the introduction of pay for performance.

Conclusion: The quality of chronic disease management in England was broadly equitable between socioeconomic groups before this major pay for performance programme and remained so after its introduction.

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