QOF must target ethnic health inequalities, researchers say

QOF should include indicators to cut disparities in outcomes between different ethnic groups, researchers have said.

Blood glucose test. Drop of blood on a patient's finger (SPL)
Blood glucose test. Drop of blood on a patient's finger (SPL)

Across two studies, Dr Christopher Millet and his Imperial College London colleagues found QOF failed to reduce inequalities across ethnic groups.

When the researchers looked at management of stroke, BP and CHD, they found evidence of systolic BP reductions in white and black hypertension patients. But these reductions were not seen in South Asian patients, and disparities in risk control remained across ethnic groups.

For diabetes outcomes, the researchers found that disparities in risk factor control remained across ethnic groups after the introduction of QOF.

'Our findings support the view that targeted quality improvement strategies may be required to address disparities in chronic disease management,' they said. 'Designers of pay for performance should weight the effect of such schemes on minority patients and consider incorporating targeted incentives.'

Dr Wasim Hanif, diabetes chairman at the South Asian Health Foundation, said the failure of QOF to reduce ethnic disparities meant a new approach was needed.

'If this important initiative, which has had investment, has not been able to address health inequalities, we need to look at new initiatives, including targets and training,' he said.


- PLoS One Online 2012 and Ann Fam Med 2012; 10: 228-34.

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