scholarly journals What drives general practitioners in the UK to improve the quality of care? A systematic literature review

2021 ◽  
Vol 10 (1) ◽  
pp. e001127
Author(s):  
Kanwal Ahmed ◽  
Salma Hashim ◽  
Mariyam Khankhara ◽  
Ilhan Said ◽  
Amrita Tara Shandakumar ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Financial Incentives ◽  
Pay For Performance ◽  
Health Management ◽  
Quality Care ◽  
Positive Effects ◽  
The Uk

BackgroundIn the UK, the National Health Service has various incentivisation schemes in place to improve the provision of high-quality care. The Quality Outcomes Framework (QOF) and other Pay for Performance (P4P) schemes are incentive frameworks that focus on meeting predetermined clinical outcomes. However, the ability of these schemes to meet their aims is debated.Objectives(1) To explore current incentive schemes available in general practice in the UK, their impact and effectiveness in improving quality of care and (2) To identify other types of incentives discussed in the literature.MethodsThis systematic literature review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Six databases were searched: Cochrane, PubMed, National Institute for Health and Care Excellence Evidence, Health Management Information Consortium, Embase and Health Management. Articles were screened according to the selection criteria, evaluated against critical appraisal checklists and categorised into themes.Results35 articles were included from an initial search result of 22087. Articles were categorised into the following three overarching themes: financial incentives, non-financial incentives and competition.DiscussionThe majority of the literature focused on QOF. Its positive effects included reduced mortality rates, better data recording and improved sociodemographic inequalities. However, limitations involved decreased quality of care in non-incentivised activities, poor patient experiences due to tick-box exercises and increased pressure to meet non-specific targets. Findings surrounding competition were mixed, with limited evidence found on the use of non-financial incentives in primary care.ConclusionCurrent research looks extensively into financial incentives, however, we propose more research into the effects of intrinsic motivation alongside existing P4P schemes to enhance motivation and improve quality of care.

scholarly journals Effectiveness of UK provider financial incentives on quality of care: a systematic review

2017 ◽  
Vol 67 (664) ◽  
pp. e800-e815 ◽  
Author(s):  
Rishi Mandavia ◽  
Nishchay Mehta ◽  
Anne Schilder ◽  
Elias Mossialos
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Quality Of Care ◽  
Quality Of Health Care ◽  
Financial Incentives ◽  
Healthcare Quality ◽  
Standards Of Care ◽  
Positive Effects ◽  
The Uk

BackgroundProvider financial incentives are being increasingly adopted to help improve standards of care while promoting efficiency.AimTo review the UK evidence on whether provider financial incentives are an effective way of improving the quality of health care.Design and settingSystematic review of UK evidence, undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations.MethodMEDLINE and Embase databases were searched in August 2016. Original articles that assessed the relationship between UK provider financial incentives and a quantitative measure of quality of health care were included. Studies showing improvement for all measures of quality of care were defined as ‘positive’, those that were ‘intermediate’ showed improvement in some measures, and those classified as ‘negative’ showed a worsening of measures. Studies showing no effect were documented as such. Quality was assessed using the Downs and Black quality checklist.ResultsOf the 232 published articles identified by the systematic search, 28 were included. Of these, nine reported positive effects of incentives on quality of care, 16 reported intermediate effects, two reported no effect, and one reported a negative effect. Quality assessment scores for included articles ranged from 15 to 19, out of a maximum of 22 points.ConclusionThe effects of UK provider financial incentives on healthcare quality are unclear. Owing to this uncertainty and their significant costs, use of them may be counterproductive to their goal of improving healthcare quality and efficiency. UK policymakers should be cautious when implementing these incentives — if used, they should be subject to careful long-term monitoring and evaluation. Further research is needed to assess whether provider financial incentives represent a cost-effective intervention to improve the quality of care delivered in the UK.

scholarly journals Review: Relation Between Quality-of-Care Indicators for Diabetes and Patient Outcomes: A Systematic Literature Review

2011 ◽  
Vol 68 (3) ◽  
pp. 263-289 ◽  
Author(s):  
Grigory Sidorenkov ◽  
Flora M Haaijer-Ruskamp ◽  
Dick de Zeeuw ◽  
Henk Bilo ◽  
Petra Denig
Keyword(s):  
Quality Of Care ◽  
Literature Review ◽  
Patient Outcomes ◽  
Systematic Literature Review

scholarly journals Themes Related to Experienced Quality of Care in Nursing Homes From the Resident’s Perspective: A Systematic Literature Review and Thematic Synthesis

2020 ◽  
Vol 6 ◽  
pp. 233372142093196
Author(s):  
Katya Y. J. Sion ◽  
Hilde Verbeek ◽  
Sandra M. G. Zwakhalen ◽  
Gaby Odekerken-Schröder ◽  
Jos M. G. A. Schols ◽  
...  
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Nursing Homes ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Social Engagement ◽  
Centered Care ◽  
Meaningful Relationships ◽  
And Coping

Background: The culture change from task-centered care to person- and relationship-centered care has resulted in the resident’s voice gaining importance when assessing experienced quality of care in nursing homes. This review aimed to identify which factors contribute to experienced quality of care in nursing homes worldwide from the resident’s perspective. Method: A systematic literature review and thematic data synthesis were performed. The databases PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, and Business Source Complete were searched to identify qualitative studies aimed at retrieving factors related to residents’ experienced quality of care in nursing homes. Only studies in which residents themselves were interviewed were included. Results: This literature review included 27 publications covering 14 countries. Thematic analysis revealed three overarching themes related to residents’ care experiences: (a) The nursing home environment consisted of the physical environment and caring environment, (b) individual aspects of living in the nursing home consisted of personhood and coping with change, and (c) social engagement consisted of meaningful relationships and care provision. Discussion: To achieve high experienced quality of care in nursing homes, residents’ care experiences need to be assessed and used in quality management.

Mobile health interventions for cancer care and support: A systematic literature review (Preprint)

2019 ◽  
Author(s):  
Amandeep Dhir
Keyword(s):  
Literature Review ◽  
Cancer Patients ◽  
Systematic Literature Review ◽  
Mobile Health ◽  
Cancer Awareness ◽  
Positive Effects ◽  
Care And Support ◽  
Centered Care ◽  
Research Findings

UNSTRUCTURED The use of mobile health (mHealth) interventions for improving quality of life (QoL) is increasing. There is a clear surge in the number of mHealth interventions for cancer patients, but the related research findings are fragmented. There is an urgent need to amalgamate the extant findings, particularly those related to reviews of the effects of mHealth interventions on cancer awareness and screening. The current study systematically review the available literature on mHealth interventions for cancer patients and survivors with a view to synthesizing the outcomes and the effects of these interventions on disease management: from awareness to survival. The study utilizes systematic literature review (SLR) and examined of 57 published studies (number of participants = 112,196) that described mHealth interventions for various types of cancer. Most of the studies found that mHealth interventions had positive effects on cancer survivors, caregiver teams, and family members. Several randomized controlled trials (RCTs) suggested that mHealth provides person-centered care in the clinical management of cancer and improves survivorship care. The SLR findings suggest that mHealth interventions should be based on theory and defined frameworks.

Achieving better quality care in general practice: are incentives the answer?

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711461
Author(s):  
Kanwal Ahmed ◽  
Salma Hashim ◽  
Mariyam Khankhara ◽  
Ilhan Said ◽  
Amrita Shandakumar ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Intrinsic Motivation ◽  
Financial Incentives ◽  
Quality Care ◽  
Healthcare Providers ◽  
Structured Interviews ◽  
Multiple Indicators ◽  
Improved Outcomes ◽  
Quality And Outcomes

BackgroundThe introduction of financial incentives, such as the quality and outcomes framework (QOF), historically lead to improvements in standardising practice. However, with shifting demands on healthcare providers, are these schemes still enough to drive high-quality care?AimTo explore current incentives, intrinsic and extrinsic, their role and effectiveness in improving quality of care and how they are perceived by GPs.MethodMixed methods study using two systematic literature reviews including 44 papers and 18 semi-structured interviews with GPs.ResultsIn the literature, QOF was associated with reduced socioeconomic inequalities, decreased mortality and improved outcomes. However, the absence of control groups and the simultaneous analysis of multiple indicators complicates the findings. GPs agreed with the literature and viewed financial incentives as beneficial, however, they felt the key driver in providing good-quality care was their intrinsic motivation. Financial incentives were found to contribute to depersonalised care, diluted provision of non-incentivised activities and hindered overall practice. The results from the second literature review were in keeping with the views of the participants. They illustrated the importance of managing factors contributing to physician burnout, reduced performance, and low job satisfaction, which can result in the provision of low-quality care.ConclusionFinancial incentives have the potential to induce behaviour change, however, their use in quality improvement is limited when used alone. If used in an environment that nurtures intrinsic motivation, healthcare providers will be more driven to achieve a higher quality of care and will be better able to cope with shifting demands.

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