Influence of a Pay-for-Performance Program on Glycemic Control in Patients Living with Diabetes by Family Physicians in a Canadian Province
| Autor: | Beverly Greene, Mathieu Bélanger, Lise Babin, Emilie LeBlanc, Michelina Mancuso, Stuart Halpine, Veronique Thibault |
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| Rok vydání: | 2017 |
| Předmět: |
Blood Glucose
Male Canada Pediatrics medicine.medical_specialty Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Pay for performance Odds 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Endocrinology Diabetes mellitus Diabetes Mellitus Internal Medicine medicine Humans Incentive program 030212 general & internal medicine Reimbursement Incentive Aged Glycemic Glycated Hemoglobin business.industry Physicians Family General Medicine Middle Aged medicine.disease 3. Good health Physician Incentive Plans Incentive chemistry Cohort Emergency medicine Female Glycated hemoglobin business |
| Zdroj: | Canadian Journal of Diabetes. 41:190-196 |
| ISSN: | 1499-2671 |
| DOI: | 10.1016/j.jcjd.2016.09.008 |
| Popis: | Objectives We evaluated the influence of the introduction of a pay-for-performance program implemented in 2010 for family physicians on the glycemic control of patients with diabetes. Methods Administrative data for all 583 eligible family physicians and 83,580 adult patients with diabetes in New Brunswick over 10 years were used. We compared the probability of receiving at least 2 tests for glycated hemoglobin (A1C) levels and achieving glycemic control before (2005–2009) and after (2010–2014) the implementation of the program and between patients divided based on whether a physician claimed the incentive or did not. Results Patients living with diabetes showed greater odds of receiving at least 2 A1C tests per year if the detection of their diabetes occurred after (vs. before) the implementation of the program (OR, 99% CI=1.23, 1.18 to 1.28), if a physician claimed the incentive (vs. not claiming it) for their care (1.92, 1.87 to 1.96) in the given year, and if they were followed by a physician who ever (vs. never) claimed the incentive (1.24, 1.15 to 1.34). In a cohort-based analysis, patients for whom an incentive was claimed (vs. not claimed) had greater odds of receiving at least 2 A1C tests per year before implementation of the incentive, and these odds increased by 56% (1.49 to 1.62) following its implementation. However, there was no difference in A1C values among the various comparison groups. Conclusions Introduction of the incentive was associated with greater odds of having a minimum of 2 A1C tests per year, which may suggest that it led physicians to provide better follow-up care for patients with diabetes. However, the incentive program has not been associated with differences in glycemic control. |
| Databáze: | OpenAIRE |
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