Document Detail


A Longitudinal Examination of a Pay-for-Performance Program for Diabetes Care: Evidence From a Natural Experiment.
MedLine Citation:
PMID:  22249920     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: : Numerous studies have examined the impacts of pay-for-performance programs, yet little is known about their long-term effects on health care expenses.
OBJECTIVES: : This study aimed to examine the long-term effects of a pay-for-performance program for diabetes care on health care utilization and expenses.
METHODS: : This study represents a nationwide population-based natural experiment with a 4-year follow-up period under a compulsory universal health insurance program in Taiwan. The intervention groups consisted of 20,934 patients enrolled in the program in 2005, and 9694 patients continuously participated in the program for 4 years. Two comparison groups were selected by propensity score matching from patients seen by the same group of physicians. Generalized estimating equations were used to estimate differences-in-differences models to examine the effects of the pay-for-performance program.
RESULTS: : Patients enrolled in the pay-for-performance program underwent significantly more diabetes specific examinations and tests after enrollment; the differences between the intervention and comparison groups declined gradually over time but remained significant. Patients in the intervention groups had a significantly higher number of diabetes-related physician visits in only the first year after enrollment and had fewer diabetes-related hospitalizations in the follow-up period. Concerning overall health care expenses, patients in the intervention groups spent more than the comparison group in the first year; however, the continual enrollees spent significantly less than their counterparts in the subsequent years.
CONCLUSIONS: : The program seemed to achieve its primary goal in improving health care and providing long-term cost benefits.
Authors:
Shou-Hsia Cheng; Tai-Ti Lee; Chi-Chen Chen
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Medical care     Volume:  50     ISSN:  1537-1948     ISO Abbreviation:  Med Care     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0230027     Medline TA:  Med Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  109-16     Citation Subset:  IM    
Affiliation:
*Institute of Health Policy and Management, College of Public Health, National Taiwan University †Bureau of National Health Insurance, Department of Health, Executive Yuan, Taiwan.
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