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

Filetype[PDF-447.64 KB]


  • English
    • Details Supporting Files You May Also Like

    Details:

    • Alternative Title:
      Prev Chronic Dis
    • Publisher's site:
      http://dx.doi.org/10.5888/pcd14.170012
    • Personal Author:
    • 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 subdistribution 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.

    • Subject:
    • Source:
      Prev Chronic Dis. 14.
    • Pubmed ID:
      28981404
    • Pubmed Central ID:
      PMC5645199
    • Document Type:
      Journal Article
    • Place as Subject:
      Taiwan
    • Collection(s):
      Preventing Chronic Disease
    • Main Document Checksum:
    • File Type:

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