Details:

Alternative Title:
Prev Chronic Dis
Publisher's site:
http://dx.doi.org/10.5888/pcd14.170012
Personal Author:
Hsieh, Hui-Min; He, Jiun-Shiuan; Shin, Shyi-Jang; Chiu, Herng-Chia; Lee, Charles Tzu-Chi;
Hsieh, Hui-Min; He, Jiun-Shiuan; Shin, Shyi-Jang; Chiu, Herng-Chia; Lee, Charles Tzu-Chi; Less -
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:
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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

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:
[+]
urn:sha256:2ef44559a564ddb67e1cb28e280c03fbc757bc3a994fef0a1984faf95d9a6c9d
File Type:

Supporting Files

• 	PCD-14-E88.nxml	xml
  	PCD-14-E88s01.gif	gif
  	PCD-14-E88s01.jpg	jpeg

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