Abstract

The UK’s Quality and Outcomes Framework (QOF) is the largest pay-for-performance scheme in the world. This ethnographic study explored how QOF’s monetary logic influences the approach to healthcare in UK general practice. From August 2013 to April 2014, we researched two UK general practice surgeries and one general practice training programme. These environments provided the opportunity for studying various spaces such as QOF meetings, consultation rooms, QOF recoding sessions, and the collection of computer-screen images depicting how patients’ biomarkers are evaluated and costed through software systems. QOF as a biomedical technology has led to the commodification of patients and their bodies. This complex phenomenon breaks down into three main themes: commodification of patients, QOF as currency, and valuing commodities. Despite the ostensible aim of QOF being to improve healthcare in general practice, it is accompanied by a body commodification process. The interface between patients and care providers has been commodified, with QOF’s pricing mechanism and fragmentation of care provision performing an important role in animating the UK economy.

Armando H. Norman a, * Andrew J. Russell b, Claudia Merli b
a Health Secretariat of Rio de Janeiro Municipality, Family and Community Medicine Specialty Training Programme
b Durham University, Anthropology Department, Dawson Building, South Road, DH1 3LE Durham, County Durham, United Kingdom
Article – Social Science& Medicine – Elsevier Ltd. All rights reserved.

Leia artigo completo – artigo24_10_2016-1