Ashworth Mark, Kordowicz Maria
Department of Primary Care and Public Health Sciences, King's College London School of Medicine, London, UK.
Qual Prim Care. 2010;18(2):127-31.
Since its inception in 2004 the Quality and Outcomes Framework (QOF) has become embedded in the fabric of day-to-day general practice. Yet despite some of its tangible successes, the QOF's vulnerability to gaming poses challenges to its applicability as the dominant quality improvement framework in primary care. This paper questions whether high QOF scores amount to better care or simply the illusory effects of better data recording. Suggestions for developing QOF are made in the light of its limitations as a public health improvement initiative.
自2004年启动以来，质量与结果框架（QOF）已融入日常全科医疗的结构之中。然而，尽管该框架取得了一些切实的成功，但它易受“对策行为”影响的特点，对其作为初级医疗中主导的质量改进框架的适用性构成了挑战。本文质疑QOF的高分究竟意味着更好的医疗服务，还是仅仅是更好的数据记录所产生的虚幻效果。鉴于其作为公共卫生改善举措的局限性，本文提出了改进QOF的建议。
