The impact of diabetes pay-for-performance program on hyperglycemic hyperosmolar state (HHS)

Abstract Background To examine the effects of a diabetes pay-for-performance (P4P) program on the negative metabolic outcome: hyperglycemic hyperosmolar state (HHS) of patients in Taiwan. Methods Four years (2008∼2011) of data from the National Health Insurance Administration (NHIA) databases were examined. P4P patients included those who were newly enrolled in the P4P group in 2010, and consecutively included in 2011. Patients were never enrolled are defined as non-P4P group in these two years. The caliper matching method and a generalized estimating equation were used to estimate difference-in-differences models (baseline year 2009) and examine the effects of the P4P program on the count of the adverse outcome. Results The P4P program was associated with decreases in the incident of HHS (IRR 0.53, P = 0.02). Conclusions The disease management component of the diabetes P4P program can be beneficial for reducing the incidences of HHS. Key messages • The disease management component of the diabetes P4P program can be beneficial for reducing the incidences of HHS. • The disease management component of the diabetes P4P program is important.