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
  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
• Download URL:
  https://stacks.cdc.gov/view/cdc/49457/cdc_49457_DS1.pdf
• File Type:
  [PDF - 447.64 KB]
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:dd0241138d7d0c159581f7d131ebe62965c6c55bd5ee248b8c53ee9c49ae17694167af18ac87e16ecb21d184480a3e32dfae68f3ac79b7e909e39595c402a062