The association of clinical guideline adherence and pay-for-performance among patients with diabetes

Journal of the Chinese Medical Association

Volumn 76, Issue 2, 2013, Pages 102-107

  Lai, Chiu Ling ^a   Hou, Ying Hui ^b  

^a NATIONAL TAIWAN UNIVERSITY   (Taiwan)

^b KAINAN UNIVERSITY   (Taiwan)

Author keywords

Diabetes mellitus; Guideline adherence; Pay for performance; Taiwan

Indexed keywords

ALANINE AMINOTRANSFERASE; CREATININE; GLUCOSE; HEMOGLOBIN A1C; INSULIN; LIPID;

ADULT; ARTICLE; CONTROLLED STUDY; CREATININE BLOOD LEVEL; CROSS-SECTIONAL STUDY; DIABETES MELLITUS; DIABETES MELLITUS PAY FOR PERFORMANCE; DIABETIC DIET; DIABETIC PATIENT; EYE EXAMINATION; FEMALE; GLUCOSE BLOOD LEVEL; HEALTH CARE DELIVERY; HEALTH PROGRAM; HUMAN; MAJOR CLINICAL STUDY; MALE; PHYSICIAN; PRACTICE GUIDELINE; URINALYSIS;

ADULT; AGED; CROSS-SECTIONAL STUDIES; DIABETES MELLITUS; FEMALE; GUIDELINE ADHERENCE; HEMOGLOBIN A, GLYCOSYLATED; HUMANS; MALE; MIDDLE AGED; REIMBURSEMENT, INCENTIVE;

EID: 84872685473     PISSN: 17264901     EISSN: 17287731     Source Type: Journal    
DOI: 10.1016/j.jcma.2012.06.024     Document Type: Article

References (34)

1. International Diabetes Federation. IDF Diabetes Atlas 5th edition. IDF Website. [accessed 24.04.12]. http://www.idf.org/diabetesatlas/5e/.
2. Glickman S.W., Peterson E.D. Innovative health reform models: pay-for-performance initiative. Am J Manag Care 2009, 15:S300-S305.
3. Alshamsan R., Millett C., Majeed A., Khunti K. Has pay for performance improved the management of diabetes in the United Kingdom?. Prim Care Diabetes 2010, 4:73-78.
4. de Bruin R.S., Baan C.A., Struijs J.N. Pay-for-performance in disease management: a systematic review of the literature. BMC Health Serv Res 2011, 11:272.
5. Gilmore A.S., Zhao Y., Kang N., Ryskina K.L., Legorreta A.P., Taira D.A., et al. Patient outcomes and evidence-based medicine in a preferred provider organization setting: a six-year evaluation of a physician pay-for-performance program. Health Serv Res 2007, 42:2140-2159.
6. Chen J.Y., Tian H., Taira Juarez D., Hodges K.A., Brand J.C., Chung R.S., et al. The effect of a PPO pay-for-performance program on patients with diabetes. Am J Manag Care 2010, 16:e11-e19.
7. Rosenthal M.B., de Brantes F.S., Sinaiko A.D., Frankel M., Robbins R.D., Young S. Bridges to excellence-recognizing high-quality care: analysis of physician quality and resource use. Am J Manag Care 2008, 14:670-677.
8. Chen J.Y., Kang N., Juarez D.T., Hodges K.A., Chung R.S. Impact of a pay-for-performance program on low performing physicians. J Healthc Qual 2010, 32:13-22.
9. Young G.J., Meterko M., Beckman H., Baker E., White B., Sautter K.M., et al. Effects of paying physicians based on their relative performance for quality. J Gen Intern Med 2007, 22:872-876.
10. Rosenthal M.B., Frank R.G., Li Z., Epstein A.M. Early experience with pay-for-performance: from concept to practice. JAMA 2005, 294:1788-1793.
11. Department of Health. Statistics of National Health Insurance medical expenditure, year 2010. DOH Website. [accessed 24.04.12] [in Chinese]. http://www.doh.gov.tw/CHT2006/DM/DM2_2.aspx%3fnow_fod_list_no%3d12021%26class_no%3d440%26level_no%3d3.
12. Chang H.Y., Hsu C.C., Pan W.H., Liu W.L., Cheng J.Y., Tseng C.H., et al. Gender differences in trends in diabetes prevalence from 1993 to 2008 in Taiwan. Diabetes Res Clin Pract 2010, 90:358-364.
13. Chuang L.M., Tsai S.T., Huang B.Y., Tsai T.Y. The current state of diabetes management in Taiwan. Diabetes Res Clin Pract 2001, 54:S55-S65. Diabcare (Taiwan) Study Group.
14. Yu N.C., Su H.Y., Tsai S.T., Lin B.J., Shiu R.S., Hsieh Y.C., et al. ABC control of diabetes: survey data from national diabetes health promotion centers in Taiwan. Diabetes Res Clin Prac 2009, 84:194-200.
15. Tseng F.Y., Lai M.S., Syu C.Y., Lin C.C. Professional accountability for diabetes care in Taiwan. Diabetes Res Clin Prac 2006, 71:192-201.
16. Tseng F.Y., Lai M.S. Effects of physician specialty on use of antidiabetes drugs, process and outcomes of diabetes care in a medical center. J Formos Med Assoc 2006, 105:821-831.
17. Lin W., Chang R.E., Yaung C.L. Exploring variation in quality of diabetic care among different medical specialties. J Med Education 2002, 7:271-281. [in Chinese].
18. Lee T.T., Cheng S.H., Chen C.C., Lai M.S. A pay-for-performance program for diabetes care in Taiwan: a preliminary assessment. Am J Manag Care 2010, 16:65-69.
19. Cheng S.H., Lee T.T., Chen C.C. A longitudinal examination of a pay-for-performance program for diabetes care: evidence from a natural experiment. Med Care 2012, 50:109-116.
20. Chang R.E., Lin S.P., Aron D.C. A pay-for-performance program in Taiwan improved care for some diabetes patients, but doctors may have excluded sicker ones. Health Aff (Millwood) 2012, 31:93-102.
21. Lin W., Hsieh C.J., Chiou S.J., Wu H.Y., Huang I.C. An effectiveness evaluation of a pay-for-performance program for diabetes based on the propensity score matching method. Taiwan J Public Health 2010, 29:54-63. [in Chinese].
22. Chen T.T., Chung K.P., Lin I.C., Lai M.S. The unintended consequences of diabetes mellitus pay-for-performance (P4P) program in Taiwan: are patients with more comorbidities or more severe conditions likely to be excluded from the P4P program. Health Serv Res 2011, 46:47-60.
23. Greenfield S., Kaplan S.H., Kahn R., Ninmiya J., Griffith J.L. Profiling care provided by different groups of physicians: effects of patient case-mix (bias) and physician-level clustering on quality assessment results. Ann Intern Med 2002, 136:111-121.
24. Pham H.H., Schrag D., O'Malley A.S., Wu B., Bach P.B. Care patterns in Medicare and their implications for pay for performance. N Engl J Med 2007, 356:1130-1139.
25. Young B.A., Lin E., Von Korff M., Simon G., Ciechanowski P., Ludman E.J., et al. Diabetes complications severity index and risk of mortality, hospitalization, and healthcare utilization. Am J Manag Care 2008, 14:15-23.
26. Schwartz L.M., Woloshin S., Welch H.G. Misunderstandings about the effect of race and sex on physicians' referrals for cardiac catheterization. N Engl J Med 1999, 341:279-283.
27. Zhang J., Yu K.F. What's the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. JAMA 1998, 280:1690-1691.
28. Davis D., O'Brien M.A., Freemantle N., Wolf F.M., Mazmanian P., Taylor-Vaisey A. Impact of formal continuing medical education: do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes?. JAMA 1999, 282:867-874.
29. Dalton A.R., Alshamsan R., Majeed A., Millett C. Exclusion of patients from quality measurement of diabetes care in the UK pay-for-performance programme. Diabet Med 2011, 28:525-531.
30. Bainbridge K.E., Cowie C.C., Rust K.F., Fradkin J.E. Mitigating case mix factors by choice of glycemic control performance measure threshold. Diabetes Care 2008, 31:1754-1760.
31. Cabana M.D., Rand C.S., Powe N.R., Wu A.W., Wilson M.H., Abboud P.A., et al. Why don't physicians follow clinical practice guidelines? A framework for improvement. JAMA 1999, 282:1458-1465.
32. Doran T., Fullwood C., Reeves D., Gravelle H., Roland M. Exclusion of patients from pay-for-performance targets by English physicians. N Engl J Med 2008, 359:274-284.
33. van Ryn M., Burke J. The effect of patient race and socio-economic status on physicians' perceptions of patients. Soc Sci Med 2000, 50:813-828.
34. Karter A.J., Ferrara A., Darbinian J.A., Ackerson L.M., Selby J.V. Self-monitoring of blood glucose: language and financial barriers in a managed care population with diabetes. Diabetes Care 2000, 23:477-483.