A Diabetes Pay-for-Performance Program and Risks of Cancer Incidence and Death in Patients With Type 2 Diabetes in Taiwan

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Hsieh, Hui-Min ; He, Jiun-Shiuan ; Shin, Shyi-Jang ; Chiu, Herng-Chia ; Lee, Charles Tzu-Chi
• Description:
  Introduction
  
  We sought to evaluate the effects of diabetes disease management through a diabetes pay-for-performance (P4P) program in Taiwan on risks of incident cancer and mortality among patients with type 2 diabetes.
  
  Methods
  
  We conducted a longitudinal observational cohort study using 3 population-based databases in Taiwan. Using propensity score matching, we compared patients with type 2 diabetes who enrolled in a P4P program with a similar group of patients who did not enroll in the in P4P program (non-P4P). Primary end points of interest were risks of incident cancer and all-cause, cancer-specific, and diabetes-related mortality. Total person-years and incidence and mortality rates per 1,000 person-years were calculated. Multivariable Cox proportional hazard models and competing risk regression were used in the analysis.
  
  Results
  
  Overall, our findings indicated that the diabetes P4P program was not significantly associated with lower risks of cancer incidence, but it was associated with lower risks of all-cause mortality (adjusted sub distribution hazard ratio [aSHR], 0.59; 95% confidence interval [CI], 0.55–0.63), cancer-specific mortality (aSHR, 0.85; 95% CI, 0.73–1.00), and diabetes-related mortality (aSHR, 0.54: 95% CI, 0.49–0.60). Metformin, thiazolidinediones, and α glucosidase inhibitors were associated with lower risks of cancer incidence and cancer-specific mortality.
  
  Conclusion
  
  Our findings provide evidence of the potential benefit of diabetes P4P programs in reducing risks of all-cause mortality and competing causes of death attributable to cancer-specific and diabetes-related mortality among type 2 diabetes patients.
  
  
• Subjects:
  Cohort Studies Diabetes Mellitus, Type 2 Female Humans Longitudinal Studies Male Middle Aged National Health Programs Neoplasms Proportional Hazards Models Reimbursement, Incentive Risk Reduction Behavior

  More +
• Source:
  Prev Chronic Dis. 14.
• DOI:
  http://dx.doi.org/10.5888/pcd14.170012
• ISSN:
  1545-1151
• Pubmed ID:
  28981404
• Pubmed Central ID:
  PMC5645199
• Document Type:
  Journal Article
• Place as Subject:
  Taiwan
• Location:
  Asia
• Volume:
  14
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:dd0241138d7d0c159581f7d131ebe62965c6c55bd5ee248b8c53ee9c49ae17694167af18ac87e16ecb21d184480a3e32dfae68f3ac79b7e909e39595c402a062
• Download URL:
  https://stacks.cdc.gov/view/cdc/49457/cdc_49457_DS1.pdf
• File Type:
  [PDF - 447.64 KB ]