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- Page navigation anchor for Rolling the dice with quality initiativesRolling the dice with quality initiativesFilling check boxes, crossing the Ts and dotting the Is—this has become the future of medicine. Inexorably, there are challenges which continue to present with today’s wide use of electronic medical records, rushed clinical encounters, insurance companies’ tight grasp on physician compensation and growing government influence on healthcare. Meeting predetermined standards to assess quality measures has become an arduous, even ambitious task. They are time intensive and require multi-level coordination. However, they have shown positive patient outcomes.For instance, widespread vaccination in the 20th century contributed to halting the spread of infectious diseases such as rubella, polio and measles.1 Most recently, in 2003 to 2012, the use of statin medication in the United States increased from 18% to 26%, cholesterol numbers down-trended and the age-adjusted death rate from heart disease and diabetes declined by 23% in males respectively and 27% and 21% in females.2-3. Furthermore, from 2004-2014, the percentage of adults who smoked cigarettes declined for women aged 18-44 and for both men and women aged 45-64. There was a simultaneous decrease in age-adjusted death rates for chronic lower respiratory diseases and cancer.3 This was no coincidence, but a small sample of the success stories as a result of nationwide quality initiatives, such as the Healthcare Effectiveness Data and Informa...Show MoreCompeting Interests: None declared.
- Page navigation anchor for QOF: is it worthwhileQOF: is it worthwhile
Des Spence, in his July article in the BJGP, adds to the growing chorus suggesting QOF has done little if anything in terms of health improvement, or rather the quoted evidence suggests this. But let's just hold fire before we get criticised again for our work and income. Life expectancy is increasing, premature mortality is decreasing, but our disease 'counting' has also increased. Yes QOF, especially in the last few years, has had targets that make no scientific sense and is contrary to the idea of shared patient care and often logic and plain common sense. But there are practices where for a variety of reasons care is suboptimal and the patients registered have morbidity and mortality that are increased compared to their locality. If these can be identified through QOF and help given, nobody is the loser.
Competing Interests: None declared.