Weblog entry #272 for simonw
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#272
10% more diabetes and hypothyroidism
Posted by simonw on Fri 8 Aug 2008 at 00:58
The Quality and Outcomes Framework in the UK is designed to measure the performance of General Practice (doctor's surgeries).
I was somewhat skeptical since the points awarded for hypothyroidism are on the basis of knowing which of your patients are hypothyroid. Then additional points are awarded based on the proportion of those patients who have had a thyroid function test in the last 15 months. In my view, this is pretty much the minimum standard of care one might expect for someone with hypothyroidism, hence my skepticism.
However it is interesting to note that the prevalence of diabetes and hypothyroidism measured by the QOF has increased by about 10% each. The change is most likely mainly an artifact of the process, reflecting that doctor can now correctly report the existence of 10% more such patients. But it is a significant increase in number of patients known to be receiving at least the "minimum standard of care".
Whether this reflects a genuine improvement in the care received, or merely improvements in the ability of GP surgeries to report the care they are providing is another question. I trust it doesn't reflect a 10% increase in endocrine disorders.
Prevalence figures are based on number of patients registered with a GP, and may thus overstate the actual prevalence of a disease (since, we hope, people not registered with a GP are in generally good health).
http://www.ic.nhs.uk/cmsincludes/_process_document.asp?sPublicationID=1174988969611&sDocID=3163
I was somewhat skeptical since the points awarded for hypothyroidism are on the basis of knowing which of your patients are hypothyroid. Then additional points are awarded based on the proportion of those patients who have had a thyroid function test in the last 15 months. In my view, this is pretty much the minimum standard of care one might expect for someone with hypothyroidism, hence my skepticism.
However it is interesting to note that the prevalence of diabetes and hypothyroidism measured by the QOF has increased by about 10% each. The change is most likely mainly an artifact of the process, reflecting that doctor can now correctly report the existence of 10% more such patients. But it is a significant increase in number of patients known to be receiving at least the "minimum standard of care".
Whether this reflects a genuine improvement in the care received, or merely improvements in the ability of GP surgeries to report the care they are providing is another question. I trust it doesn't reflect a 10% increase in endocrine disorders.
Prevalence figures are based on number of patients registered with a GP, and may thus overstate the actual prevalence of a disease (since, we hope, people not registered with a GP are in generally good health).
http://www.ic.nhs.uk/cmsincludes/_process_document.asp?sPublicationID=1174988969611&sDocID=3163