Dr Mark Morgan, Greater Green Triangle, Department of Rural Health, Flinders and Deakin University Funding: PHCRED Research Fellow Team member: Dr Adrian Elliot-Smith

Strengthening preventive and chronic disease care and improving performance and accountability are priorities for reforming the Australian primary health care system. Measuring and rewarding quality care in a workable way is a challenge.

Since 2004, a proportion of UK GP incomes has been based on performance against a framework of quality indicators. These indicators emphasise reward for clinical outcome, in addition to activity. How do Australian GP outcomes compare with the UK? A group practice in regional South Australia undertook this original study to find out how an Australian practice would perform under the UK policy model, and whether it could use its clinical software program to obtain relevant clinical outcome data.

A search of 16,314 patient records at the practice was undertaken and showed it was possible to examine the quality of chronic disease management using almost all of the UK indicators. This research demonstrated, for the first time, that it is possible to examine the quality of chronic disease management in an Australian practice by identifying important clinical outcomes using a series of computer searches. Of the available UK scheme points, 66 per cent were achieved – equal to a bonus payment of $296,000. Gaps in care were also uncovered. These can now be easily monitored by the same computerised searches. The methodology also allows international benchmarking and provides significant new knowledge about practice and policy activities to influence the quality of medical care provided.