PMID- 32238389
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 2398-3795 (Electronic)
IS  - 2398-3795 (Linking)
VI  - 4
IP  - 2
DP  - 2020
TI  - The effect of 'paying for performance' on the management of type 2 diabetes 
      mellitus: a cross-sectional observational study.
LID - bjgpopen20X101021 [pii]
LID - 10.3399/bjgpopen20X101021 [doi]
AB  - BACKGROUND: The 'cycle of care' (COC) pay for performance (PFP) programme, 
      introduced in 2015, has resourced Irish GPs to provide structured care to PCRS 
      eligible patients with type 2 diabetes mellitus (T2DM). AIM: To investigate the 
      effect of COC on management processes. DESIGN &SETTING: Cross-sectional 
      observational study undertaken with two points of comparison (2014 and 2017) in 
      participating practices (Republic of Ireland general practices), with comparator 
      data from the United Kingdom National Diabetes Audit (UKNDA) 2015-2016. METHOD: 
      Invitations to participate were sent to practices using a discussion forum for 
      Health One clinical software. Participating practices provided data on the 
      processes of care in the management of patients with T2DM. Data on PCRS eligible 
      patients was extracted from the electronic medical record system of participating 
      practices using secure customised software. Descriptive analysis, using IBM SPSS 
      Statistics for Windows (version 25), was performed. RESULTS: Of 250 practices 
      invited, 41 practices participated (16.4%), yielding data from 3146 patients. 
      There were substantial improvements in the rates of recording of glycosylated 
      haemoglobin ([HbA1c] 53.1%-98.3%), total cholesterol ([TC] 59.2%-98.8%), urinary 
      albumin:creatinine ratio ([ACR] 9.9%-42.3%), blood pressure ([BP] 61.4%-98.2%), 
      and body-mass index ([BMI] 39.8%-97.4%) from 2014 to 2017. For the first time, 
      rates of retinopathy screening (76.3%), foot review (64.9%), and influenza 
      immunisation (69.9%) were recorded. Comparison of 2017 data with UKNDA 2015-2016 
      was broadly similar. CONCLUSION: The COC demonstrated much improved rates of 
      recording of clinical and biochemical parameters, and improved achievement of 
      targets in TC and BP, but not HbA1c. Results demonstrate substantial improvements 
      in the processes and quality of care in the management of patients with T2DM.
CI  - Copyright (c) 2020, The Authors.
FAU - O'Connor, Raymond
AU  - O'Connor R
AD  - Senior Research Fellow, Department of General Practice, Graduate Entry Medical 
      School, University of Limerick, Plassey, Limerick, Republic of Ireland 
      Raymond.oconnor@ul.ie.
FAU - O'Driscoll, Rory
AU  - O'Driscoll R
AD  - GP, Kenmare Primary Health Centre, Kenmare, Kerry, Republic of Ireland.
FAU - O'Doherty, Jane
AU  - O'Doherty J
AD  - Research Assistant, Department of General Practice, Graduate Entry Medical 
      School, University of Limerick, Plassey, Limerick, Republic of Ireland.
FAU - Hannigan, Ailish
AU  - Hannigan A
AD  - Professor of Medical Statistics, Graduate Entry Medical School, University of 
      Limerick, Plassey, Limerick, Republic of Ireland.
FAU - O'Neill, Aoife
AU  - O'Neill A
AD  - PhD Candidate, Department of Mathematics and Statistics, University of Limerick, 
      Plassey, Limerick, Republic of Ireland.
FAU - Teljeur, Conor
AU  - Teljeur C
AD  - Chief Scientist, Health Information and Quality Authority, Dublin, Republic of 
      Ireland.
FAU - O'Regan, Andrew
AU  - O'Regan A
AD  - Senior Lecturer, Department of General Practice, Graduate Entry Medical School, 
      University of Limerick, Plassey, Limerick, Republic of Ireland.
LA  - eng
PT  - Journal Article
DEP - 20200623
PL  - England
TA  - BJGP Open
JT  - BJGP open
JID - 101713531
PMC - PMC7330226
OTO - NOTNLM
OT  - diabetes mellitus
OT  - general practice
OT  - pay for performance
OT  - primary healthcare
OT  - quality improvement
OT  - reimbursement, incentive
EDAT- 2020/04/03 06:00
MHDA- 2020/04/03 06:01
PMCR- 2020/04/01
CRDT- 2020/04/03 06:00
PHST- 2019/08/31 00:00 [received]
PHST- 2019/09/29 00:00 [accepted]
PHST- 2020/04/03 06:00 [pubmed]
PHST- 2020/04/03 06:01 [medline]
PHST- 2020/04/03 06:00 [entrez]
PHST- 2020/04/01 00:00 [pmc-release]
AID - bjgpopen20X101021 [pii]
AID - 01021 [pii]
AID - 10.3399/bjgpopen20X101021 [doi]
PST - epublish
SO  - BJGP Open. 2020 Jun 23;4(2):bjgpopen20X101021. doi: 10.3399/bjgpopen20X101021. 
      Print 2020.