Impact of pay for performance on quality of chronic disease management by social class group in England
Impact of pay for performance on quality of chronic disease management by social class group in England
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DOI：
10.1258/jrsm.2009.080389
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发表时间：
2009-03-01
影响因子：
17.3
通讯作者：
Millett, Christopher
中科院分区：
文献类型：
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作者：
Crawley, Danielle;Ng, Anthea;Millett, Christopher
目的 研究 2004 年引入主要绩效薪酬计划之前和之后英国社会阶层与选定的冠心病 (CHD)、糖尿病和高血压国家审计目标实现情况之间的关系。设计对 2003 年和 2006 年冠心病、糖尿病和高血压受访者的全国调查数据进行二次分析。设置英国。主要结果测量国家血压、血糖和胆固醇控制审计目标的实现情况。结果与手册中的个人血压目标实现情况没有显着差异。以及非体力劳动职业群体在实行绩效工资之前或之后患有糖尿病（2003 年：65.9% 对 60.3%，2006 年：676% 对 69.7%）或高血压（2003 年：66.2% 对 66.2%，2006 年：72.8% 对 71.9%）。患有糖尿病（2003 年：52.5% vs 46.6%，2006 年：68.7% vs 70.5%）或冠心病（2003 年：54.3% vs 53.3%，2006 年：68.6% vs 71.3%）的体力劳动组和非体力劳动组个体的胆固醇目标实现情况也相似。 CHD 患者血压目标实现情况存在差异 [75.8% vs 84.5%； AOR 0.44 (0.21-0.90)]在引入绩效工资后，体力劳动和非体力职业群体之间的差异很明显。结论 在这项主要的绩效工资计划实施之前，英国慢性病管理的质量在社会经济群体之间大体上是公平的，并且在引入之后仍然如此。
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: 676% 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.