Introduction: Numerous studies have examined the impact of pay-for-performance (P4P) programmes, yet little is known regarding their effects on continuity of care (COC) and the role of multiple chronic conditions (MCCs). This study aimed to examine the effects of a P4P programme for diabetes care on health care provision, COC and health care outcomes in diabetic patients with and without comorbid hypertension.
Methods: This study utilized a large-scale natural experiment with a 4-year follow-up period under a compulsory universal health insurance programme in Taiwan. The intervention groups consisted of patients with diabetes who were enrolled in the P4P programme in 2005. The comparison groups were selected via propensity score matching with patients who were seen by the same group of physicians. A difference-in-differences analysis was conducted using generalized estimating equation models to examine the effects of the P4P programme.
Results: Significant impacts were observed after the implementation of the P4P programme for diabetic patients with and without hypertension. The programme increased the number of necessary examinations/tests and improved the COC between patients and their physicians. The programme significantly reduced the likelihood of diabetes-related hospital admissions and emergency department visits [odds ratio (OR): 0.71; 95% confidence interval (CI): 0.63-0.80 for diabetic patients with hypertension; OR: 0.74; 95% CI: 0.64-0.86 for patients without hypertension]. However, the effects of the P4P programme diminished to some extent in the second year after its implementation.
Conclusion: This study suggests that a financial incentive programme may improve the provision of necessary health care, COC and health care outcomes for diabetic patients both with and without comorbid hypertension. Health authorities could develop policies to increase participation in P4P programmes and encourage continued improvement in health care outcomes.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/heapol/czv024 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
No prediction without prevention: A global qualitative study of attitudes toward using a prediction tool for risk of developing depression during adolescence.
Glob Ment Health (Camb)
January 2025
Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Given the rate of advancement in predictive psychiatry, there is a threat that it outpaces public and professional willingness for use in clinical care and public health. Prediction tools in psychiatry estimate the risk of future development of mental health conditions. Prediction tools used with young populations have the potential to reduce the worldwide burden of depression.
View Article and Find Full Text PDFChallenges and strategies for improving medication adherence among adolescent psychiatric patients: A qualitative study.
Glob Ment Health (Camb)
December 2024
Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Despite significant advancements in the development of psychotropic medications, increasing adherence rates remain a challenge in the treatment and management of psychiatric disorders. The purpose of this study is to qualitatively explore the challenges underlying medication adherence and strategies to improve it among adolescents with psychiatric disorders in Malaysia. This qualitative research design presents results from 17 semi-structured interviews with adolescent psychiatric patients, aged 11 to 19 years old, from public hospitals across Peninsular Malaysia.
View Article and Find Full Text PDFCombining a guided self-help and brief alcohol intervention to improve mental health and reduce substance use among refugee men in Uganda: a cluster-randomized feasibility trial.
Glob Ment Health (Camb)
November 2024
Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Evidence on the effectiveness and implementation of mental health and psychosocial support (MHPSS) interventions for men in humanitarian settings is limited. Moreover, engagement and retention of men in such interventions has been challenging. Adaptations may therefore be required to improve the appropriateness and acceptability of these interventions for men.
View Article and Find Full Text PDFPathways to care for psychosis in rural Uganda: Mixed-methods study of individuals with psychosis, family members, and local leaders.
Glob Ment Health (Camb)
January 2025
Department of Psychiatry Mbarara University of Science and Technology, Mbarara, Uganda.
Background: Low- and middle-income countries (LMICs) bear a disproportionate burden of mental illness, with limited access to biomedical care. This study examined pathways to care for psychosis in rural Uganda, exploring factors influencing treatment choices.
Methods: We conducted a mixed-methods study in Buyende District, Uganda, involving 67 in-depth interviews and 4 focus group discussions (data collection continued until thematic saturation was reached) with individuals with psychotic disorders, family members, and local leaders.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!