Professor James contributed to the design and analysis and wrote the text for the article. Ms Stokes undertook statistical analysis of the raw data, prepared the graphs and made some revisions to the draft article.
Spending by primary care practices—does it show what we expect?
Article first published online: 7 NOV 2013
© 2013 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
The International Journal of Health Planning and Management
Volume 29, Issue 3, pages 244–259, July/September 2014
How to Cite
2014), Spending by primary care practices—does it show what we expect?, Int J Health Plann Mgmt, 29, 244–259. doi: 10.1002/hpm.2224and (
- Issue published online: 4 AUG 2014
- Article first published online: 7 NOV 2013
- Manuscript Accepted: 2 OCT 2013
- Manuscript Revised: 1 OCT 2013
- Manuscript Received: 28 MAY 2013
- primary care policy;
- QOF indicators;
Over recent years, a number of policies and financial incentives in primary care have been proposed to tackle issues such as deprivation and health outcomes. This article investigates the association between healthcare spending, deprivation and outcomes. It argues that individual practice data are analysed before blanket application and acceptance that one size fits all in a local area.
Financial data were analysed alongside key outcome data, including quality and outcomes framework (QOF) indicators for a large urban primary care trust (PCT) in the UK. The PCT had a large population and number of practices, including single-handed practices and an average list size in excess of 5000. The PCT will remain anonymous.
There was no relationship between primary care investment and the practices' deprivation score. There was a strong statistically significant negative correlation between QOF payments and deprivation, (correlation = −0.46, p < 0.001). There were only weak links between primary care investment and health outcomes. There was no relationship between high emergency spending and health outcome.
The data presented suggest that one size does not necessarily fit all—in terms of providing the appropriate incentives in primary care, nor do national incentives and policies always have the desired effect. © 2013 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd.