Cost-effectiveness of a diabetes pay-for-performance program in diabetes patients with multiple chronic conditions

PLoS ONE

Volumn 10, Issue 7, 2015, Pages

  Hsieh, Hui Min ^a   Gu, Song Mao ^b   Shin, Shyi Jang ^c,d   Kao, Hao Yun ^a   Lin, Yi Chieh ^a   Chiu, Herng Chia ^a,e  

^a KAOHSIUNG MEDICAL UNIVERSITY   (Taiwan)

^b CENTER FOR DISEASE CONTROL   (Taiwan)

^c KAOHSIUNG MEDICAL UNIVERSITY   (Taiwan)

^d KAOHSIUNG MEDICAL UNIVERSITY HOSPITAL   (Taiwan)

^e NATIONAL SUN YAT SEN UNIVERSITY   (Taiwan)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; AGED; ARTICLE; COHORT ANALYSIS; COMORBIDITY; CONTROLLED STUDY; COST CONTROL; COST EFFECTIVENESS ANALYSIS; DIABETES MELLITUS; ECONOMIC EVALUATION; FEMALE; HEALTH CARE COST; HEALTH CARE QUALITY; HUMAN; HYPERLIPIDEMIA; HYPERTENSION; INVESTMENT; LONGITUDINAL STUDY; MAJOR CLINICAL STUDY; MALE; OBSERVATIONAL STUDY; OUTPATIENT CARE; PAY FOR PERFORMANCE; QUALITY ADJUSTED LIFE YEAR; QUALITY OF LIFE; TAIWAN; CHRONIC DISEASE; COST BENEFIT ANALYSIS; ECONOMICS; MIDDLE AGED;

AGED; CHRONIC DISEASE; COMORBIDITY; COST SAVINGS; COST-BENEFIT ANALYSIS; DIABETES MELLITUS; FEMALE; HUMANS; HYPERLIPIDEMIAS; HYPERTENSION; LONGITUDINAL STUDIES; MALE; MIDDLE AGED; QUALITY OF LIFE; QUALITY-ADJUSTED LIFE YEARS; TAIWAN;

EID: 84940784222     PISSN: None     EISSN: 19326203     Source Type: Journal    
DOI: 10.1371/journal.pone.0133163     Document Type: Article

References (46)

1. Tinetti ME, Fried TR, Boyd CM. Designing health care for the most common chronic condition - multimorbidity. JAMA. 2012; 307(23):2493-4. doi: 10.1001/jama.2012.5265 PMID: 22797447; PubMed Central PMCID: PMC4083627.
2. Boyd CM, Fortin M. Future of Multimorbidity Research: How Should Understanding of Multimorbidity Inform Health System Design? Public Health Reviews. 2010; 32(2):451-74.
3. Parekh AK, Barton MB. The challenge of multiple comorbidity for the US health care system. JAMA. 2010; 303(13):1303-4. doi: 10.1001/jama.2010.381 PMID: 20371790.
4. Piette JD, Kerr EA. The impact of comorbid chronic conditions on diabetes care. Diabetes Care. 2006; 29(3):725-31. PMID: 16505540.
5. Wolff JL, Starfield B, Anderson G. Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Arch Intern Med. 2002; 162(20):2269-76. PMID: 12418941.
6. Isomaa B, Henricsson M, Almgren P, Tuomi T, Taskinen MR, Groop L. The metabolic syndrome influences the risk of chronic complications in patients with type II diabetes. Diabetologia. 2001; 44(9):1148-54. doi: 10.1007/s001250100615 PMID: 11596670.
7. Freid VM, Bernstein AB, Bush MA. Multiple chronic conditions among adults aged 45 and over: Trends over the past 10 years. NCHS data brief, no 100 Hyattsville, MD: National Center for Health Statistics. Available: http://http://wwwcdcgov/nchs/data/databriefs/db100htm (Accessed 15 Oct 2014). 2012. PMID: 23101759
8. Tseng LN, Tseng YH, Jiang YD, Chang CH, Chung CH, Lin BJ, et al. Prevalence of hypertension and dyslipidemia and their associations with micro- and macrovascular diseases in patients with diabetes in Taiwan: an analysis of nationwide data for 2000-2009. J Formos Med Assoc. 2012; 111(11):625-36. doi: 10.1016/j.jfma.2012.09.010 PMID: 23217598.
9. Isomaa B, Almgren P, Tuomi T, Forsen B, Lahti K, Nissen M, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care. 2001; 24(4):683-9. PMID: 11315831.
10. Lee TA, Shields AE, Vogeli C, Gibson TB, Woong-Sohn M, Marder WD, et al. Mortality rate in veterans with multiple chronic conditions. J Gen Intern Med. 2007; 22 Suppl 3:403-7. doi: 10.1007/s11606-007-0277-2 PMID: 18026809; PubMed Central PMCID: PMC2219704.
11. Lehnert T, Heider D, Leicht H, Heinrich S, Corrieri S, Luppa M, et al. Review: health care utilization and costs of elderly persons with multiple chronic conditions. Med Care Res Rev. 2011; 68(4):387-420. doi: 10.1177/1077558711399580 PMID: 21813576.
12. Campbell SM, Reeves D, Kontopantelis E, Sibbald B, Roland M. Effects of pay for performance on the quality of primary care in England. N Engl J Med. 2009; 361(4):368-78. doi: 10.1056/NEJMsa0807651 PMID: 19625717
13. Greene J. An examination of pay-for-performance in general practice in Australia. Health Serv Res. 2013; 48(4):1415-32. doi: 10.1111/1475-6773.12033 PMID: 23350933.
14. Boyd CM, Darer J, Boult C, Fried LP, Boult L, Wu AW. Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases: implications for pay for performance. JAMA. 2005; 294(6):716-24. doi: 10.1001/jama.294.6.716 PMID: 16091574.
15. Holman RR, Paul SK, Bethel MA, Matthews DR, Neil HA. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med. 2008; 359(15):1577-89. doi: 10.1056/NEJMoa0806470 PMID: 18784090.
16. Emmert M, Eijkenaar F, Kemter H, Esslinger AS, Schoffski O. Economic evaluation of pay-for-performance in health care: a systematic review. Eur J Health Econ. 2012; 13(6):755-67. doi: 10.1007/s10198-011-0329-8 PMID: 21660562.
17. Eijkenaar F, Emmert M, Scheppach M, Schoffski O. Effects of pay for performance in health care: a systematic review of systematic reviews. Health Policy. 2013; 110(2-3):115-30. doi: 10.1016/j.healthpol.2013.01.008 PMID: 23380190.
18. Gillam SJ, Siriwardena AN, Steel N. Pay-for-performance in the United Kingdom: impact of the quality and outcomes framework: a systematic review. Ann Fam Med. 2012; 10(5):461-8. doi: 10.1370/afm.1377 PMID: 22966110; PubMed Central PMCID: PMC3438214.
19. Meacock R, Kristensen SR, Sutton M. The cost-effectiveness of using financial incentives to improve provider quality: a framework and application. Health Econ. 2014; 23(1):1-13. doi: 10.1002/hec.2978 PMID: 23943496.
20. de Bruin SR, Baan CA, Struijs JN. Pay-for-performance in disease management: a systematic review of the literature. BMC Health Serv Res. 2011; 11:272. doi: 10.1186/1472-6963-11-272 PMID: 21999234; PubMed Central PMCID: PMC3218039.
21. Petersen LA, Woodard LD, Urech T, Daw C, Sookanan S. Does pay-for-performance improve the quality of health care? Ann Intern Med. 2006; 145(4):265-72. PMID: 16908917.
22. Nahra TA, Reiter KL, Hirth RA, Shermer JE, Wheeler JR. Cost-effectiveness of hospital pay-for-performance incentives. Med Care Res Rev. 2006; 63(1 Suppl):49S-72S. PMID: 16688924.
23. Tan EC, Pwu RF, Chen DR, Yang MC. Is a diabetes pay-for-performance program cost-effective under the National Health Insurance in Taiwan? Qual Life Res. 2013. doi: 10.1007/s11136-013-0502-x PMID: 23975377.
24. Hsieh HM, Tsai SL, Shin SJ, Mau LW, Chiu HC. Cost-effectiveness of diabetes pay-for-performance incentive designs. Med Care. 2015; 53(2):106-15. doi: 10.1097/MLR.0000000000000264 PMID: 25397966.
25. Cheng SH, Lee TT, Chen CC. A longitudinal examination of a pay-for-performance program for diabetes care: evidence from a natural experiment. Med Care. 2012; 50(2):109. doi: 10.1097/MLR.0b013e31822d5d36 PMID: 22249920
26. Chen CC, Tseng CH, Cheng SH. Continuity of care, medication adherence, and health care outcomes among patients with newly diagnosed type 2 diabetes: a longitudinal analysis. Med Care. 2013; 51(3):231-7. doi: 10.1097/MLR.0b013e31827da5b9 PMID: 23269110.
27. Chen TT, Chung KP, Lin I, Lai MS. The Unintended Consequence 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(1p1):47-60.
28. Pham HH, Schrag D, O'Malley AS, Wu B, Bach PB. Care patterns in Medicare and their implications for pay for performance. N Engl J Med. 2007; 356(11):1130-9. doi: 10.1056/NEJMsa063979 PMID: 17360991.
29. Young BA, Lin E, Von Korff M, Simon G, Ciechanowski P, Ludman EJ, et al. Diabetes complications severity index and risk of mortality, hospitalization, and healthcare utilization. Am J Manag Care. 2008; 14(1):15-23. PMID: 18197741.
30. Deyo RA, Cherkin DC, Ciol MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol. 1992; 45(6):613-9. PMID: 1607900.
31. Meduru P, Helmer D, Rajan M, Tseng CL, Pogach L, Sambamoorthi U. Chronic illness with complexity: implications for performance measurement of optimal glycemic control. J Gen Intern Med. 2007; 22 Suppl 3:408-18. doi: 10.1007/s11606-007-0310-5 PMID: 18026810; PubMed Central PMCID: PMC2150612.
32. Dehejia RH, Wahba S. Propensity score-matching methods for nonexperimental causal studies. The review of economics and statistics. 2002; 84(1):151-61.
33. Austin PC. A critical appraisal of propensity-score matching in the medical literature between 1996 and 2003. Stat Med. 2008; 27(12):2037-49. doi: 10.1002/sim.3150 PMID: 18038446.
34. Brazier JE, Roberts J. The estimation of a preference-based measure of health from the SF-12. Med Care. 2004; 42(9):851-9. PMID: 15319610.
35. Pickard AS, Wang Z, Walton SM, Lee TA. Are decisions using cost-utility analyses robust to choice of SF-36/SF-12 preference-based algorithm? Health Qual Life Outcomes. 2005; 3:11. doi: 10.1186/1477-7525-3-11 PMID: 15748287; PubMed Central PMCID: PMC555748.
36. Brazier J, Roberts J, Deverill M. The estimation of a preference-based measure of health from the SF-36. J Health Econ. 2002; 21(2):271-92. PMID: 11939242.
37. Gold MR, Siegel JE, Russel LB, Weinstein MC. Cost-Effectiveness in Health and Medicine Oxford University Press: New York. 1996.
38. Drummond MF, O'Brien B, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes. Oxford University Press: Oxford, United Kindom. 1987.
39. Weintraub WS, Cohen DJ. The limits of cost-effectiveness analysis. Circ Cardiovasc Qual Outcomes. 2009; 2(1):55-8. doi: 10.1161/CIRCOUTCOMES.108.812321 PMID: 20031813.
40. Cromwell J, Smith KW. Evaluating Pay for Performace Interventions. in "Pay for Performance in Health Care: Methods and Approaches", edited by Cromwell J, Trisolini M G, Pope G C, Mitchell J B, and Greenwald L M, RTI Press Publication No BK-0002-1103 Research Triangle Park, NC: RTI Press Accessed 15 May 2013 Available: http://wwwrtiorg/rtipress. 2011.
41. Lee TT, Cheng SH, Chen CC, Lai MS. A pay-for-performance program for diabetes care in Taiwan: a preliminary assessment. Am J Manag Care. 2010; 16(1):65-9. PMID: 20148607.
42. Vaghela P, Ashworth M, Schofield P, Gulliford MC. Population intermediate outcomes of diabetes under pay-for-performance incentives in England from 2004 to 2008. Diabetes Care. 2009; 32(3):427-9. doi: 10.2337/dc08-1999 PMID: 19106379; PubMed Central PMCID: PMC2646022.
43. Curtin K, Beckman H, Pankow G, Milillo Y, Green RA. Return on investment in pay for performance: a diabetes case study. J Healthc Manag. 2006; 51(6):365-74; discussion 75-6. PMID: 17184001.
44. American Diabetes Association. Standards of Medical Care in Diabetes-2014. Diabetes care. 2014; 37(1):S14-S80.
45. Glasziou P, Alexander J, Beller E, Clarke P, Group AC. Which health-related quality of life score? A comparison of alternative utility measures in patients with Type 2 diabetes in the ADVANCE trial. Health Qual Life Outcomes. 2007; 5:21. doi: 10.1186/1477-7525-5-21 PMID: 17462100; PubMed Central PMCID: PMC1950473.
46. Mangin D, Heath I, Jamoulle M. Beyond diagnosis: rising to the multimorbidity challenge. BMJ. 2012; 344:e3526. doi: 10.1136/bmj.e3526 PMID: 22695898.