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Long-term evidence for the effect of pay-for-performance in primary care on mortality in the UK: a population study

Overview of attention for article published in The Lancet, May 2016
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (97th percentile)

Mentioned by

news
77 news outlets
blogs
4 blogs
twitter
289 tweeters
facebook
3 Facebook pages
wikipedia
1 Wikipedia page

Readers on

mendeley
54 Mendeley
citeulike
1 CiteULike
Title
Long-term evidence for the effect of pay-for-performance in primary care on mortality in the UK: a population study
Published in
The Lancet, May 2016
DOI 10.1016/s0140-6736(16)00276-2
Pubmed ID
Authors

Andrew M Ryan, Sam Krinsky, Evangelos Kontopantelis, Tim Doran, Ryan, Andrew M, Krinsky, Sam, Kontopantelis, Evangelos, Doran, Tim

Abstract

Introduced in 2004, the UK's Quality and Outcomes Framework (QOF) is the world's largest primary care pay-for-performance programme. We tested whether the QOF was associated with reduced population mortality. We used population-level mortality statistics between 1994 and 2010 for the UK and other high-income countries that were not exposed to pay-for-performance. The primary outcome was age-adjusted and sex-adjusted mortality per 100 000 people for a composite outcome of chronic disorders that were targeted by the QOF. Secondary outcomes were age-adjusted and sex-adjusted mortality for ischaemic heart disease, cancer, and a composite of all non-targeted conditions. For each study outcome, we created a so-called synthetic UK as a weighted combination of comparison countries. We then estimated difference-in-differences models to test whether mortality fell more in the UK than in the synthetic UK after the QOF. Introduction of the QOF was not significantly associated with changes in population mortality for the composite outcome (-3·68 per 100 000 population [95% CI -8·16 to 0·80]; p=0·107), ischaemic heart disease (-2·21 per 100 000 [-6·86 to 2·44]; p=0·357), cancer (0·28 per 100 000 [-0·99 to 1·55]; p=0·679), or all non-targeted conditions (11·60 per 100 000 [-3·91 to 27·11]; p=0·143). Although we noted small mortality reductions for a composite outcome of targeted disorders, the QOF was not associated with significant changes in mortality. Our findings have implications for the probable effects of similar programmes on population health outcomes. The relation between incentives and mortality needs to be assessed in specific disease domains. None.

Twitter Demographics

The data shown below were collected from the profiles of 289 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 54 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 3 6%
Unknown 51 94%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 11 20%
Researcher 11 20%
Other 9 17%
Student > Master 7 13%
Student > Bachelor 4 7%
Other 12 22%
Readers by discipline Count As %
Medicine and Dentistry 18 33%
Social Sciences 11 20%
Business, Management and Accounting 7 13%
Economics, Econometrics and Finance 6 11%
Unspecified 4 7%
Other 8 15%

Attention Score in Context

This research output has an Altmetric Attention Score of 836. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 15 May 2018.
All research outputs
#3,775
of 10,696,187 outputs
Outputs from The Lancet
#112
of 28,021 outputs
Outputs of similar age
#286
of 277,618 outputs
Outputs of similar age from The Lancet
#13
of 580 outputs
Altmetric has tracked 10,696,187 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 28,021 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 29.4. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 277,618 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 580 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 97% of its contemporaries.