Diabetic Patients In Pay-for-Performance Programs Have Better Survival Rates
Patients who are participating in "pay-for-performance" medical programs are more likely to receive continuity of care from physicians and have higher survival rates, a new study has found. The study included nearly 400,000 diabetic patients in both pay-for-performance (P4P) and other non-P4P care options.
A total of 396,838 patients were followed, with about half being in a P4P program and the other half being in other types of patient care programs. The study followed the patients from 1997 to 2009. All of the patients were in Taiwan and all were diagnosed with differing types of diabetes with a roughly equal mix of types between the two groups.
The Continuity of Care Index (COCI) score for patients in P4P programs was much better and death rates were lower.
Taiwan introduced a diabetes P4P program in 2001 in which physicians could voluntarily participate. Their fees and management fees were tied to quality of performance with patients, based on four indicators, with fees being higher if the physician scored well on the performance assessments. The program was designed to improve patient care and encourage patients to be more participatory in their own care and has had the side-effect of physician continuity being higher in patients who are participating - another key indicator of quality of care.
The study found that mortality rates among diabetic patients in the P4P program were far better than with those who were not in the program. This is critical in nations where following up with a doctor is not required by patients, who are free to see any physician they wish.