The British journal of general practice : the journal of the Royal College of General Practitioners
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Multicenter Study
Diabetes care and the new GMS contract: the evidence for a whole county.
The aim of this study was to assess the impact of the Quality and Outcomes Framework (QOF) of the new GP contract on diabetes care in Shropshire, which has a total population of approximately 460 000. The mean percentage of patients achieving each of the quality indicators in each practice in Shropshire, before and after the implementation of the QOF was calculated. All 16 867 patients with diabetes from all 66 Shropshire practices were included. There were significant improvements in the percentage of patients achieving targets for all quality indicators between April 2004 to March 2006 (P<0.001).
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Multicenter Study
Quality of clinical primary care and targeted incentive payments: an observational study.
Payments for recorded evidence of quality of clinical care in UK general practices were introduced in 2004. ⋯ The introduction of financial incentives was associated with substantial apparent quality improvement for incentivised conditions. For non-incentivised conditions, quality did not appear to improve. Patients with non-incentivised conditions may be at risk of poorer quality care.
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This study describes a novel type of support for GPs caring for patients dying at home: the establishment and evaluation of a telephone advisory service for GPs, run by GPs with a special interest in palliative care (GPwSIs) in the Netherlands 2000-2003. A growing number of GPs called for advice, 10% during out of hours. Prognosis of the patients was generally short (days to weeks in 70% of cases). Most advice sought by GPs concerned symptom management and on evaluation, 85% of the GPs followed the advice.
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There is evidence that African-Caribbean people with diabetes have poorer outcomes than other individuals with diabetes. It is not fully understood why this happens. ⋯ These findings have implications for how some people manage their diabetes and how diabetes care is delivered to the African-Caribbean community.