Does pay-for-performance benefit patients with multiple chronic conditions? Evidence from a universal coverage health care system

Health Policy and Planning

Volumn 31, Issue 1, 2016, Pages 83-90

  Chen, Chi Chen ^a   Cheng, Shou Hsia ^b  

^a FU JEN CATHOLIC UNIVERSITY   (Taiwan)

^b NATIONAL TAIWAN UNIVERSITY   (Taiwan)

Author keywords

Continuity of care; diabetes mellitus; health care outcomes; multiple chronic conditions; pay for performance programme

Indexed keywords

AGED; CHRONIC DISEASE; COMORBIDITY; COMPARATIVE STUDY; ECONOMICS; FACTUAL DATABASE; FEMALE; HEALTH CARE DELIVERY; HEALTH CARE QUALITY; HUMAN; INSURANCE; MALE; MIDDLE AGED; OUTCOME ASSESSMENT; PATIENT CARE; REIMBURSEMENT; STATISTICS AND NUMERICAL DATA; TAIWAN;

AGED; CHRONIC DISEASE; COMORBIDITY; CONTINUITY OF PATIENT CARE; DATABASES, FACTUAL; DELIVERY OF HEALTH CARE; FEMALE; HUMANS; MALE; MIDDLE AGED; OUTCOME ASSESSMENT (HEALTH CARE); QUALITY ASSURANCE, HEALTH CARE; REIMBURSEMENT, INCENTIVE; TAIWAN; UNIVERSAL COVERAGE;

EID: 84966400920     PISSN: 02681080     EISSN: 14602237     Source Type: Journal    
DOI: 10.1093/heapol/czv024     Document Type: Article

References (43)

1. Anderson G. 2010. Chronic Conditions: Making the Case for Ongoing Care. Princeton, NJ: Robert Wood Johnson Foundation and JohnHopkins University.
2. Beaulieu ND, Horrigan DR. 2005. Putting smart money to work for quality improvement. Health Services Research 40: 1318-34.
3. Bice TW, Boxerman SB. 1977. A quantitative measure of continuity of care. Medical Care 15: 347-9.
4. BoydCM, Darer J, Boult C et al. 2005. Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases: implications for pay for performance. The Journal of the American Medical Association 294: 716-24.
5. Bray K, Turpin RS, Jungkind K, Heuser G. 2008. Defining success in diabetes diseasemanagement: digging deeper in the data. DiseaseManagement 11: 119-28.
6. Campbell SM, Reeves D, Kontopantelis E, Sibbald B, Roland M. 2009. Effects of pay for performance on the quality of primary care in England. The New England Journal of Medicine 361: 368-78.
7. Centers for Medicare&Medicaid Services. Medicare physician group practice demonstration. https://www. cms. gov/Medicare/Demonstration-Projects/ DemoProjectsEvalRpts/downloads/PGP-Fact-Sheet. pdf, accessed 21 August 2014.
8. Chang RE, Lin SP, Aron DC. 2012. A pay-for-performance program in Taiwan improved care for some diabetes patients, but doctors may have excluded sicker ones. Health Affairs (Millwood) 31: 93-102.
9. Chen TJ, Chou LF, Hwang SJ. 2006. Patterns of ambulatory care utilization in Taiwan. BMC Health Services Research 6: 54.
10. Chen TT, Chung KP, Lin IC, Lai MS. 2011. 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 Services Research 46: 47-60.
11. Cheng SH, Lee TT, Chen CC. 2012. A longitudinal examination of a pay-forperformance program for diabetes care: evidence from a natural experiment. Medical Care 50: 109-16.
12. Cheng TM. 2003. Taiwan's new national health insurance program: genesis and experience so far. Health Affairs (Millwood) 22: 61-76.
13. Christianson JB, Leatherman S, Sutherland K. 2008. Lessons from evaluations of purchaser pay-for-performance programs: A review of the evidence. Medical Care Research and Review 65: 5S-35S.
14. Dolor RJ, Schulman KA. 2013. Financial incentives in primary care practice: The struggle to achieve population health goals. The Journal of the American Medical Association 310: 1031-2.
15. Doran T, Fullwood C, Gravelle H, et al. 2006. Pay-for-performance programs in family practices in the United Kingdom. The New England Journal of Medicine 355: 375-84.
16. Eijkenaar F, Emmert M, Scheppach M, SchÖffski O. 2013. Effects of pay for performance in health care: A systematic review of systematic reviews. Health Policy 110: 115-30.
17. Emmert M, Eijkenaar F, Kemter H, Esslinger AS, SchÖffski O. 2012. Economic evaluation of pay-for-performance in health care: A systematic review. The European Journal of Health Economics 13: 755-67.
18. Epstein M, Sowers JR. 1992. Diabetes mellitus and hypertension. Hypertension 19: 403-18.
19. Fitzmaurice GM, Laird NM, Ware JH. 2004. Applied Longitudinal Analysis. Hoboken, NJ: Wiley.
20. Goodman RA, Parekh AK, Koh HK. 2012. Toward a more cogent approach to the challenges of multimorbidity. Annals of Family Medicine 10: 100-1.
21. Huang P, Hsu YH, Kai-Yuan T, Hsueh YS. 2000. Can European external peer review techniques be introduced and adopted into Taiwan's hospital accreditation system? International Journal forQuality in Health Care 12: 251-4.
22. Jee SH, Cabana MD. 2006. Indices for continuity of care: A systematic review of the literature. Medical Care Research and Review 63: 158-88.
23. Kristensen SR, Meacock R, Turner AJ, et al. 2014. Long-term effect of hospital pay for performance on mortality in England. The New England Journal of Medicine 371: 540-8.
24. Lee TT, Cheng SH, Chen CC, Lai MS. 2010. A pay-for-performance program for diabetes care in Taiwan: A preliminary assessment. The American Journal of Managed Care 16: 65-9.
25. Lehnert T, Heider D, Leicht H, et al. 2011. Review: health care utilization and costs of elderly persons with multiple chronic conditions. Medical Care Research and Review 68: 387-420.
26. Levin-Scherz J, DeVita N, Timbie J. 2006. Impact of pay-for-performance contracts and network registry on diabetes and asthma HEDIS measures in an integrated delivery network. Medical Care Research and Review 63: 14S-28S.
27. Meduru P, Helmer D, Rajan M, et al. 2007. Chronic illness with complexity: implications for performance measurement of optimal glycemic control. Journal of General Internal Medicine 22: 408-18.
28. Millett C, Gray J, Bottle A, Majeed A. 2008. Ethnic disparities in blood pressure management in patients with hypertension after the introduction of pay for performance. Annals of Family Medicine 6: 490-6.
29. Millett C, Bottle A, Ng A, et al. 2009. Pay for performance and the quality of diabetes management in individuals with and without co-morbid medical conditions. Journal of the Royal Society of Medicine 102: 369-77.
30. National Health Insurance Administration. 2014. Statistical trends of National Health Insurance. http://www. nhi. gov. Tw/Resource/webdata/ 23838-1-%E5%85%A8%E6%B0%91%E5%81%A5%E5%BA%B7% E4%BF%9D%E9%9A%AA%E7%B5%B1%E8%A8%88%E5%8B% 95%E5%90%91-2011%E5%B9%B4. pdf, accessed 19 December 2014.
31. National Health Insurance Administration. 2014. The participation rate of P4P programs. http://www. nhi. gov. Tw/webdata/webdata. Aspx?menu1/417& menu-id1/4659&WD-ID1/4897&webdata-id1/44531, accessed 21 August 2014.
32. Patric K, Stickles JD, Turpin RS et al. 2006. Diabetes disease management in Medicaid managed care: A program evaluation. Disease Management 9: 144-56.
33. Petersen LA, Woodard LD, Urech T, Daw C, Sookanan S. 2006. Does pay-forperformance improve the quality of health care? Annals of Internal Medicine 145: 265-72.
34. Rosenbaum PR, Rubin DB. 1983. The central role of the propensity score in observational studies for causal effects. Biometrika 70: 41-55.
35. Rosenthal MB, Frank RG. 2006. What is the empirical basis for paying for quality in health care? Medical Care Research and Review 63: 135-57.
36. Shen Y. 2003. Selection incentives in a performance-based contracting system. Health Services Research 38: 535-52.
37. Smedby O, Eklund G, Eriksson EA, Smedby B. 1986. Measures of continuity of care. A register-based correlation study. Medical Care 24: 511-8.
38. Stark RG, Schunk MV, Meisinger C et al. 2011. Medical care of type 2 diabetes in German disease management programmes: A population-based evaluation. Diabetes/Metabolism Research and Reviews 27: 383-91.
39. Tinetti ME, Bogardus ST Jr, Agostini JV. 2004. Potential pitfalls of diseasespecific guidelines for patients with multiple conditions. The New England Journal of Medicine 351: 2870-4.
40. Van Herck P, De Smedt D, Annemans L et al. 2010. Systematic review: effects, design choices, and context of pay-for-performance in health care. BMC Health Services Research 10: 247.
41. Whyte S, Penny C, Phelan M, Hippisley-Cox J, Majeed A. 2007. Quality of diabetes care in patients with schizophrenia and bipolar disorder: crosssectional study. Diabetic Medicine 24: 1442-8.
42. Young BA, Lin E, Von Korff M et al. 2008. Diabetes complications severity index and risk of mortality, hospitalization, and healthcare utilization. The American Journal of Managed Care 14: 15-23.
43. Yu HC, Tsai WC, Kung PT. 2014. Does the pay-for-performance programme reduce the emergency department visits for hypoglycaemia in type 2 diabetic patients? Health Policy and Planning 29: 732-41.