Effectiveness of Pay-for-Performance Incentive Designs on Diabetes Care
Bibliographic Data
| ID | 9103881 |
|---|---|
| Authors | Hui-Min Hsieh (0000-0003-3286-7306, Department of Public Health, corresponding author), Shyi-Jang Shin (Kaohsiung Medical University), Shyi‐Jang Shin (0000-0001-5074-8488, Kaohsiung Medical University), Shu-Ling Tsai (0000-0001-5516-043X, Bureau of National Health Insurance, Ministry of Health and Welfare, Taipei), Shu‐Ling Tsai (Ministry of Health and Welfare), Herng-Chia Chiu (0000-0002-6561-5685, Research Education and Epidemiology Center, Changhua Christian Hospital, Changhua City) |
| Year | 2016 |
| Volume | 54 |
| Issue | 12 |
| Pages | 1063-1069 |
| Publication date | 2016-12-01 |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0000000000000609 |
| PMID | 27479599 |
| OpenAlex | W2493275694 |
| Language | EN |
| Citations received | 1 |
| References cited | 24 |
BACKGROUND: Taiwan's National Health Insurance program implemented a pay-for-performance (P4P) program based on process measures in 2001. In late 2006, the P4P was revised to also include achievement of outcome measures. OBJECTIVES: This study examined whether a change in P4P incentive design structure affected diabetes outcomes. RESEARCH DESIGN AND METHOD: We used a longitudinal cohort study design using 2 population-based databases. Newly enrolled P4P patients with diabetes in 2002-2003 (phase 1) and 2007-2008 (phase 2) made up the study cohorts. Propensity score matching was used to match comparable cohorts in each phase. In total, 46,286 matched cohorts in phase 1 and 2 were analyzed. Process measures were defined as the provision of tests of glycosylated hemoglobin A1c (HbA1c), low-density lipoprotein cholesterol, and blood pressure, and outcome measures as changes in those values between baseline and last follow-up within 3 years. Patient-level generalized linear regression models were used and patient characteristics, physician characteristics, and health care facility characteristics were adjusted for. RESULTS: Our results indicated that the process measures of HbA1c and low-density lipoprotein cholesterol tests did not differ significantly between the 2 phases. In addition, better improvements were noted in outcome measures for the phase 2 patients (ie, HbA1c level and lipid profiles), whereas nonincentivized intermediate measures (eg, blood pressure) showed no negative unintended consequences. CONCLUSIONS: Quality of care tended to be better when both process and targeted outcome measures were combined as quality metrics in the P4P program in Taiwan
Cohort study · Diabetes mellitus · Environmental health · Incentive · Incentive program · Pay for performance · Physical therapy · Population · Propensity score matching · Research design · Statistics · Demography · Healthcare Policy and Management · Healthcare Systems and Reforms · Internal Medicine · Mathematics · Medicine · Primary Care and Health Outcomes
Effects of pay for performance in health care
A critical appraisal of propensity‐score matching in the medical literature between 1996 and 2003
Propensity Score-Matching Methods for Nonexperimental Causal Studies
A Longitudinal Examination of a Pay-for-Performance Program for Diabetes Care
Cost-Effectiveness of Diabetes Pay-for-Performance Incentive Designs
| Citations per year | 0.2 |
|---|---|
| Citation span | 2021 - 2021 (1) |
| Highly cited | No |