1. Long-term outcomes of the pay-for-performance program for patients with young-onset (20–40 years of age) type 2 diabetes
- Author
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Fu-Shun, Yen, James, Cheng-Chung Wei, Yu-Tung, Hung, Chih-Cheng, Hsu, and Chii-Min, Hwu
- Subjects
Cohort Studies ,Endocrinology ,Diabetes Mellitus, Type 2 ,Cardiovascular Diseases ,Endocrinology, Diabetes and Metabolism ,Taiwan ,Internal Medicine ,Humans ,General Medicine ,Reimbursement, Incentive ,Proportional Hazards Models - Abstract
To investigate the long-term outcomes of Pay-for-Performance (P4P) care in patients with young-onset (20-40 years of age) diabetes (YOD).We recruited 3088 pairs of propensity-score matched patients with and without P4P care from the National Health Insurance Research Database between January 1, 2001, and December 31, 2017. The study used a multivariable Cox regression model to compare the risks of mortality, hospitalization for cardiovascular events, and major microvascular outcomes in YOD patients with and without P4P care.The multivariable-adjusted model showed that patients with P4P care had significantly lower risks of mortality (aHR 0.31, 95% CI 0.25-0.38) and hospitalization for cardiovascular events (aHR 0.63, 95% CI 0.5-0.79) but a significantly higher risk of major microvascular outcomes (aHR 1.31, 95% CI 1.07-1.6). Patients with a longer cumulative duration of P4P and complete P4P care showed further lower risks of mortality, hospitalization for cardiovascular events, and major microvascular outcomes than those without P4P care.This nationwide cohort study showed that young-onset diabetes patients with P4P care had lower risks of death and cardiovascular events but a higher risk of major microvascular outcomes. However, patients with a longer duration of P4P care showed lower risks of these outcomes.
- Published
- 2022