Exception reporting used to boost practice profits

Practices performing poorly in the quality and outcomes framework (QOF) are using exception reporting to boost their profits, according to a study from the Centre for Health Economics

Using QOF data from practices in Scotland researchers found that those who performed worse in 2004/5 QOF results were more likely to have high exception reporting in 2005/6.

They estimated that more than 10 per cent of patients were inappropriately reported as exceptions.

'Exception reporting removes incentives towards inappropriate or overtreatment of patients. But the QOF provides perverse incentives for gaming of exceptions,' the study concluded.

The study also found that practices which performed worse in 2004/5 had lower reported prevalence in 2005/6. There was also an association between reported prevalence rates and practice characteristics, such as if a practice had been a fundholder in the past.

The researchers said that these results suggested that QOF prevalence reports may not be a reliable epidemiological resource.

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