骨关节炎是否应该有一个质量与结果框架领域？一项全科医疗中的横断面调查。

Should there be a Quality and Outcomes Framework domain for osteoarthritis? A cross-sectional survey in general practice.

作者信息

Clarson Lorna E, Nicholl Barbara I, Bishop Annette, Edwards John, Daniel Rebecca, Mallen Christian

机构信息

Research Institute for Primary Care and Health Sciences, Keele University, UK.

出版信息

Qual Prim Care. 2013;21(2):97-103.

PMID:23735690

Abstract

BACKGROUND

Despite being a chronic condition with a high prevalence and significant associated morbidity that is managed predominantly in primary care, osteoarthritis (OA) does not feature in the Quality and Outcomes Framework (QOF) component of the UK general practice contract. The aim of this study was to determine whether general practitioners (GPs) thought OA should be added as a QOF domain, and the potential items for inclusion.

METHODS

A cross-sectional postal survey of 2500 UK GPs randomly selected from Binley's database of currently practising GPs was conducted. The survey asked if OA should be added as a domain to QOF, how many points should be allocated to it and what indicators should be included.

RESULTS

Responses were received from 768 GPs, of whom 70.4% were male and 89.1% were partners in their practice. The majority (82.6%; n = 602) felt that OA should not be included as a QOF domain. Significant predictors of support for the addition of an OA domain to QOF included having a special interest in musculoskeletal disease (odds ratio [OR] 1.95, 95% confidence interval [CI] 1.26-3.03), a higher research degree (OR 3.98, 95% CI 1.31-12.10) and having read the National Institute for Health and Clinical Excellence (NICE) guidance on the management of OA (OR 1.62, 95% CI 1.04-2.54). Being a GP principal was the only negative association (OR 0.48, 95% CI 0.23-0.99). Preferred potential indicators for an OA QOF were analgesia review, exercise advice and patient education.

CONCLUSIONS

The majority of respondents felt that OA should not be included as a QOF domain, although it is unclear whether this reflected views particular to OA, or on the addition of any new domain to QOF. Those supporting an OA QOF domain tended to prefer potential indicators that are in line with current published guidance, despite a significant proportion reporting that they had not read the NICE guidelines on the management of OA.

摘要

背景

骨关节炎（OA）虽是一种慢性病，患病率高且伴有明显相关发病率，主要在初级医疗中进行管理，但它并未纳入英国全科医疗合同的质量与结果框架（QOF）部分。本研究的目的是确定全科医生（GP）是否认为OA应作为QOF领域添加，以及可能纳入的项目。

方法

对从宾利当前执业全科医生数据库中随机抽取的2500名英国全科医生进行了横断面邮寄调查。该调查询问OA是否应作为一个领域添加到QOF中，应分配多少分值以及应包括哪些指标。

结果

收到了768名全科医生的回复，其中70.4%为男性，89.1%是其所在诊所的合伙人。大多数人（82.6%；n = 602）认为OA不应作为QOF领域纳入。支持将OA领域添加到QOF的显著预测因素包括对肌肉骨骼疾病有特殊兴趣（比值比[OR] 1.95，95%置信区间[CI] 1.26 - 3.03）、拥有更高的研究学位（OR 3.98，95% CI 1.31 - 12.10）以及阅读过英国国家卫生与临床优化研究所（NICE）关于OA管理的指南（OR 1.62，95% CI 1.04 - 2.54）。担任全科诊所负责人是唯一的负相关因素（OR 0.48，95% CI 0.23 - 0.99）。OA QOF的首选潜在指标是镇痛审查、运动建议和患者教育。