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The Quality and Outcomes Framework: Body commodification in UK general practice.

Armando H Norman1, Andrew J Russell2, Claudia Merli2

  • 1Health Secretariat of Rio de Janeiro Municipality, Family and Community Medicine Specialty Training Programme, 16, Evaristo da Veiga Street, Cinelandia, 20031-040 Rio de Janeiro, RJ, Brazil.

Social Science & Medicine (1982)
|October 21, 2016
PubMed
Summary

The UK's Quality and Outcomes Framework (QOF) transforms patient care into a commodity. This pay-for-performance scheme, while aiming to improve healthcare, results in the commodification of patients and their bodies.

Keywords:
Audit cultureClinical governanceCommodificationGeneral practiceHealth policyHealth technologyPay-for-PerformanceUnited Kingdom

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Area of Science:

  • Sociology of Health and Illness
  • Health Economics
  • Medical Anthropology

Background:

  • The UK's Quality and Outcomes Framework (QOF) is the world's largest pay-for-performance scheme in primary care.
  • Understanding the influence of financial incentives on healthcare delivery is crucial.

Purpose of the Study:

  • To explore how the monetary logic of QOF influences healthcare approaches in UK general practice.
  • To investigate the phenomenon of patient commodification within the QOF system.

Main Methods:

  • Ethnographic study conducted in two UK general practices and one training program (August 2013 - April 2014).
  • Data collection included observations of QOF meetings, consultations, recoding sessions, and analysis of patient biomarker data within software systems.

Main Results:

  • QOF's financial incentives lead to the commodification of patients and their biological data.
  • Key themes identified: commodification of patients, QOF functioning as currency, and the valuation of commodities.
  • The patient-provider interface and care provision have become commodified.

Conclusions:

  • Despite aiming to improve general practice, QOF facilitates a process of body commodification.
  • The QOF pricing mechanism and fragmented care contribute to the commodification of the patient-provider interface.
  • This commodification plays a significant role in the UK economy.