ArticleDiabetes care2012
The relationship between financial incentives and quality of diabetes care in Ontario, Canada.
Article in Diabetes care, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Sex Disparities in Cardiovascular Risk Factor Assessment and Screening for Diabetes-Related Complications in Individuals With Diabetes: A Systematic Review.Frontiers in endocrinology · 2021Pooled it
- The impact of primary care reform on health system performance in Canada: a systematic review.BMC health services research · 2016Pooled it
- Effect of an educational toolkit on quality of care: a pragmatic cluster randomized trial.PLoS medicine · 2014Trial
- Strengthening preventive cancer screening in Northern Ontario, Canada: Structural supports and systemic barriers with the all nations health partners Ontario health team.Preventive medicine reports · 2026Article
- Impact of capitation payment on vascular complications among treated diabetic patients in China.Scientific reports · 2025Article
- Association of Primary Care Continuity With Home Dialysis, Transplantation, and Utilization of Medical Services for Patients Starting Hemodialysis.Kidney medicine · 2025Article
- The impact of remuneration, extrinsic and intrinsic incentives on interprofessional primary care teams: results from a rapid scoping review.BMC primary care · 2025Article
- Primary care services and emergency department visits in blended fee-for-service and blended capitation models: evidence from Ontario, Canada.The European journal of health economics : HEPAC : health economics in prevention and care · 2024Article
- Breast Cancer Screening Among Females With and Without Schizophrenia.JAMA network open · 2023Article
- Factors influencing family physician engagement in practice-based quality improvement: Qualitative study.Canadian family physician Medecin de famille canadien · 2023Article
- Primary care for individuals with serious mental illness (PriSMI): protocol for a convergent mixed methods study.BMJ open · 2022Article
- A Population-Based Analysis of Diabetes-Related Care Measures, Foot Complications, and Amputation During the COVID-19 Pandemic in Ontario, Canada.JAMA network open · 2022Article
- Physician Financial Incentives to Reduce Unplanned Hospital Readmissions: an Interrupted Time Series Analysis.Journal of general internal medicine · 2021Observational
- Comparing primary care Interprofessional and non-interprofessional teams on access to care and health services utilization in Ontario, Canada: a retrospective cohort study.BMC health services research · 2021Article
- Chronic care model in the diabetes pay-for-performance program in Taiwan: Benefits, challenges and future directions.World journal of diabetes · 2021Review
- Mediation role of perceived social support and burnout on financial satisfaction and turnover intention in primary care providers: a cross-sectional study.BMC health services research · 2021Article
- The impact of the diabetes management incentive on diabetes-related services: evidence from Ontario, Canada.The European journal of health economics : HEPAC : health economics in prevention and care · 2020Article
- Ontario's response to COVID-19 shows that mental health providers must be integrated into provincial public health insurance systems.Canadian journal of public health = Revue canadienne de sante publique · 2020Article
- Article
- Emergency Department Use and Enrollment in a Medical Home Providing After-Hours Care.Annals of family medicine · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
objectiveWe assessed the impact of a diabetes incentive code introduced for primary care physicians in Ontario, Canada, in 2002 on quality of diabetes care at the population and patient level. RESEARCH DESIGN AND
methodsWe analyzed administrative data for 757,928 Ontarians with diabetes to examine the use of the code and receipt of three evidence-based monitoring tests from 2006 to 2008. We assessed testing rates over time and before and after billing of the incentive code.
resultsOne-quarter of Ontarians with diabetes had an incentive code billed by their physician. The proportion receiving the optimal number of all three monitoring tests (HbA(1c), cholesterol, and eye tests) rose gradually from 16% in 2000 to 27% in 2008. Individuals who were younger, lived in rural areas, were not enrolled in a primary care model, or had a mental illness were less likely to receive all three recommended tests. Patients with higher numbers of incentive code billings in 2006-2008 were more likely to receive recommended testing but also were more likely to have received the highest level of recommended testing prior to introduction of the incentive code. Following the same patients over time, improvement in recommended testing was no greater after billing of the first incentive code than before.
conclusionsThe diabetes incentive code led to minimal improvement in quality of diabetes care at the population and patient level. Our findings suggest that physicians who provide the highest quality care prior to incentives may be those most likely to claim incentive payments.
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