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Which Quality and Outcomes Framework (QOF) Clinical Indicators are Applicable for British Forces Germany Health Service (BFG HS) Primary Care?
  1. HGJ van den Heuvel, Civilian Medical Practitioner1 and
  2. RG Simpson, Defence Professor of General Practice2
  1. 1Medical Centre Gütersloh, Princess Royal Barracks, British Forces Post Office 47 0049 5241 84 2536 0049 5241 84 28218 rickvandenheuvel{at}doctors.org.uk
  2. 2Royal Centre of Defence Medicine, Birmingham Research Park, Vincent Drive, Birmingham

Abstract

Objectives To determine which QOF clinical indicators are applicable for BFG HS primary care.

Method In depth cross-sectional survey of BFG HS general practitioners. Participants were requested to assess all 19 QOF clinical domains (80 clinical indicators) and to indicate to what extent these were applicable for BFG HS (Likert scale 1 – 5). Response rate was documented. Cronbach’s alpha reliability was calculated and a comparison of the mean responses of training and non-training practices was made.

Results The response rate was 80% (28/35). Cronbach’s alpha was 0.91. The mean score for both training practices and non-training practices was 3.9. Based on the mean score the applicable indicators were (in descending order): Hypothyroidism (mean 4.6, 95% confidence interval 4.5 - 4.8), Hypertension (4.6, 4.5- 4.8), Asthma (4.3, 4.2- 4.5), Diabetes mellitus (4.3, 4.2- 4.3), Obesity (4.1, 4.0- 4.2), Chronic Heart Disease (4.1, 3.9- 4.2), Epilepsy (4.0, 3.9- 4.2) and Smoking (4.0, 3.7- 4.2). Problematic were (descending means): Cancer (3.9, 3.6- 4.2), Stroke and TIA (3.8, 3.7- 4.0), Atrial fibrillation (3.6, 3.3- 3.8), Learning disabilities (3.5, 3.1- 4.0), Chronic kidney disease (3.5, 3.3- 3.8), Chronic Obstructive Pulmonary Disease (3.5, 3.3- 3.7), Mental health (3.5, 3.3- 3.6), Heart failure (3.4, 3.1- 3.7), Depression (3.2, 2.8- 3.5) and Palliative care (3.2, 2.7- 3.6). Not applicable was Dementia (2.4, 2.0- 2.8).

Conclusion This study shows that several but not all QOF clinical indicators are applicable in BFG HS. Therefore QOF cannot be directly transferred to BFH HS and an adapted quality framework is required.

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