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PLoS One. 2014 Apr 2;9(4):e92205. doi: 10.1371/journal.pone.0092205. eCollection 2014.

Impact of pay for performance on prescribing of long-acting reversible contraception in primary care: an interrupted time series study.

Author information

1
Department of Primary Care and Public Health, School of Public Health, Imperial College London, United Kingdom.

Abstract

BACKGROUND:

The aim of this study was to evaluate the impact of Quality and Outcomes Framework (QOF), a major pay-for-performance programme in the United Kingdom, on prescribing of long-acting reversible contraceptives (LARC) in primary care.

METHODS:

Negative binomial interrupted time series analysis using practice level prescribing data from April 2007 to March 2012. The main outcome measure was the prescribing rate of long-acting reversible contraceptives (LARC), including hormonal and non hormonal intrauterine devices and systems (IUDs and IUSs), injectable contraceptives and hormonal implants.

RESULTS:

Prescribing rates of Long-Acting Reversible Contraception (LARC) were stable before the introduction of contraceptive targets to the QOF and increased afterwards by 4% annually (rate ratios  = 1.04, 95% CI = 1.03, 1.06). The increase in LARC prescribing was mainly driven by increases in injectables (increased by 6% annually), which was the most commonly prescribed LARC method. Of other types of LARC, the QOF indicator was associated with a step increase of 20% in implant prescribing (RR =  1.20, 95% CI =  1.09, 1.32). This change is equivalent to an additional 110 thousand women being prescribed with LARC had QOF points not been introduced.

CONCLUSIONS:

Pay for performance incentives for contraceptive counselling in primary care with women seeking contraceptive advice has increased uptake of LARC methods.

PMID:
24694949
PMCID:
PMC3973652
DOI:
10.1371/journal.pone.0092205
[Indexed for MEDLINE]
Free PMC Article

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