Do quality improvements in primary care reduce secondary care costs?

A leading edge study published by the Health Foundation today shows an association between achievement of the Quality and Outcomes Framework (QOF) indicators and a reduction in hospital costs and lives saved, particularly for stroke care.

The primary research, which analyses newly available data to establish the impact of QOF on hospital costs and mortality, finds that a single point increase in the QOF stroke score, across England, could lead to 2,385 fewer deaths in a year.

'Do quality improvements in primary care reduce secondary care costs?' also estimates that improvements in primary care for stroke may have reduced secondary care costs by £165 million, over a four year period from 2004 to 2008, measured by a 10 per cent increase in the mean practice QOF stroke score.

Attainment of higher QOF scores in one clinical area could reduce hospital costs in other clinical areas, the report also finds.

Commenting on the report, Professor Martin Marshall, Clinical Director and Director of Research and Development at the Health Foundation, said, ‘The Health Foundation is pleased to be able to commission leading edge work such as this. As the NHS faces up to the economic crisis, it is important to understand how the service is using resources and where clinical outcomes can be improved and costs can be reduced by doing things differently.’

He continued, ‘This work reinforces the importance of investing in primary care in order to improve the use of scarce resources in the acute sector. We hope that our research findings will add to the knowledge base underpinning the decision making of clinicians, managers and policymakers.’

The research team used new advanced economic analysis methods to estimate the impact of the Quality and Outcomes Framework. The study looked at eight chronic clinical conditions:

• asthma
• chronic obstructive pulmonary disease
• coronary heart disease
• diabetes
• hypertension
• hypothyroidism
• mental health
• stroke.

The study was carried out by researchers from the Centre of Health Economics, the Department of Economics at York University, and from Imperial College Business School London.

Read the full report and summary.