Quality in primary care
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Quality in primary care · Jan 2010
Views of German general practitioners on the clinical indicators of the British Quality and Outcomes Framework: a qualitative study.
The Quality and Outcomes Framework (QOF) has had a major impact on chronic care provision in British general practice. Various countries are looking at whether a similar initiative could be used in their primary care systems. An extensive quality indicator system like the QOF does not exist in German general practice. ⋯ Participating German GPs had various concerns regarding the QOF clinical indicators and the idea of implementing a system like the QOF in German primary care. These concerns were mainly related to the validity of the indicators, the link between pay and performance, structured care versus patient centredness and the fear of external influences.
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Since its inception in 2004 the Quality and Outcomes Framework (QOF) has become embedded in the fabric of day-to-day general practice. Yet despite some of its tangible successes, the QOF's vulnerability to gaming poses challenges to its applicability as the dominant quality improvement framework in primary care. This paper questions whether high QOF scores amount to better care or simply the illusory effects of better data recording. Suggestions for developing QOF are made in the light of its limitations as a public health improvement initiative.