國家衛生研究院 NHRI:Item 3990099045/4340
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    题名: A Pay-for-Performance Program for Diabetes Care in Taiwan: A Preliminary Assessment
    作者: Lee, TT;Cheng, SH;Chen, CC;Lai, MS
    贡献者: Division of Health Policy Research and Development
    摘要: Objective: To examine the effects of a pay-for-performance (P4P) program for diabetes care in Taiwan. Study Design: A population-based natural experimental design with intervention and comparison groups. Methods: Healthcare service and expense data were extracted from the Taiwanese Bureau of National Health Insurance claim files for 2005 and 2006. The number of essential diabetes-specific exams/tests, healthcare utilization, and pre- and post-intervention expenses were calculated for patients grouped according to P4P status. However, no clinical information was available for analysis. Difference-in-difference analysis was used in statistical regression models with proper distributions for these measures. Results: Patients in the P4P program (n = 12,499) received significantly more diabetes-specific exams and tests after enrollment (3.8 vs 6.4, P < .001) than patients not enrolled in the program (3.5 vs 3.6, P <. 001). Patients in the intervention group had an average of 2 more physician visits for diabetes than those in the comparison group (P <. 001). Conversely, the intervention group had fewer diabetes-related hospitalizations (-0.027, P = .003). Patients in the intervention group incurred higher expenses due to physician visits but lower expenses due to inpatient services, with a net increase of $104 per person per year (P <. 001). Conclusions: This P4P program for diabetes was associated with a significant increase in regular follow-up visits and evidence-based services, and significantly lower hospitalization costs. The overall cost of care for those in the P4P program was significantly higher, although the total incremental expense was quite small. (Am J Manag Care. 2010; 16(1): 65-69)
    日期: 2010-01
    關聯: American Journal of Managed Care. 2010 Jan;16(1):65-69.
    Link to: http://www.ajmc.com/issue/managed-care/2010/2010-01-vol16-n01
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=1088-0224&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000274077600008
    Cited Times(Scopus): http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=75149157583
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