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Pay for performance program reduces treatment needed diabetic retinopathy - a nationwide matched cohort study in Taiwan
- Source :
- BMC Health Services Research, BMC Health Services Research, Vol 18, Iss 1, Pp 1-8 (2018)
- Publication Year :
- 2017
-
Abstract
- Background Pay-for-Performance programs have shown improvement in indicators monitoring adequacy and target achievement in diabetic care. However, less is known regarding the impact of this program on the occurrence and long-term effects of diabetic retinopathy. The objective of this study was to determine the effect of pay-for-performance program on the development of treatment needed for diabetic retinopathy in type 2 diabetes patients. Methods We conducted a nationwide retrospective cohort study with a matching design using the Taiwan National Health Insurance Research Database from 2000 to 2012. The outcome was defined as the treatment needed diabetic retinopathy. We matched Pay-for-Performance and non-Pay-for-Performance groups for age, gender, year diabetes was diagnosed and study enrollment, and duration of follow-up. Results A total of 9311 patients entered the study cohort, of whom 2157 were registered in the Pay-for-Performance group and 7154 matched in the non-Pay-for-Performance group. The incidence of treatment needed diabetic retinopathy was not significantly different in two groups. However, the incidence of treatment needed diabetic retinopathy was significantly different if restricted the non-Pay-for-Performance group who had at least 1 eye examination or optical coherence tomography within 1 year (adjusted hazard ratio, 0.78; 95% confidence interval, 0.64–0.94). Conclusions Pay-for-Performance is valuable in preventing the development of treatment needed diabetic retinopathy, which could be attributed to the routine eye examination required in the Pay-for-Performance program. We could improve our diabetic care by promoting eye health education and patient awareness on the importance of regular examinations. Electronic supplementary material The online version of this article (10.1186/s12913-018-3454-6) contains supplementary material, which is available to authorized users.
- Subjects :
- Adult
Male
Pediatrics
medicine.medical_specialty
Pay-for-performance
Databases, Factual
Quality Assurance, Health Care
NHIRD
Taiwan
030209 endocrinology & metabolism
Type 2 diabetes
03 medical and health sciences
0302 clinical medicine
Diabetes mellitus
medicine
Humans
030212 general & internal medicine
Reimbursement, Incentive
Aged
Proportional Hazards Models
Retrospective Studies
Diabetic Retinopathy
medicine.diagnostic_test
business.industry
lcsh:Public aspects of medicine
Health Policy
Incidence (epidemiology)
Incidence
Hazard ratio
lcsh:RA1-1270
Retrospective cohort study
Diabetic retinopathy
Middle Aged
medicine.disease
Diabetes Mellitus, Type 2
Eye examination
Cohort
Female
Detection bias
business
Research Article
Subjects
Details
- ISSN :
- 14726963
- Volume :
- 18
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC health services research
- Accession number :
- edsair.doi.dedup.....0bcf0faaddf26ee9bf1bba02677fc0ce