ArticleBMJ open2019
Pay-for-performance programmes reduce stroke risks in patients with type 2 diabetes: a national cohort study.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 13 citations in OpenAlex.
- Use of the Pay-for-Performance Program in Reducing Sarcopenia Risk: A Nested Case-Control Study Among Patients with Type 2 Diabetes Mellitus.Medicina (Kaunas, Lithuania) · 2026Article
- Impact of a diabetes pay-for-performance program on nonincentivized mental disorders: a panel study based on claims database analysis.Cost effectiveness and resource allocation : C/E · 2023Article
- Effects of colchicine use on ischemic and hemorrhagic stroke risk in diabetic patients with and without gout.Scientific reports · 2022Article
- Relationships Between Bronchodilators, Steroids, Antiarrhythmic Drugs, Antidepressants, and Benzodiazepines and Heart Disease and Ischemic Stroke in Patients With Predominant Bronchiectasis and Asthma.Frontiers in cardiovascular medicine · 2022Article
- Trends in all-cause mortality and major causes of death between 2007 and 2018 among patients with diabetes in Taiwan.Frontiers in endocrinology · 2022Article
- Developing a Prediction Model for 7-Year and 10-Year All-Cause Mortality Risk in Type 2 Diabetes Using a Hospital-Based Prospective Cohort Study.Journal of clinical medicine · 2021Article
- Diabetes, Vascular Aging and Stroke: Old Dogs, New Tricks?Journal of clinical medicine · 2021Review
- Adding Pay-for-Performance Program to Routine Care Was Related to a Lower Risk of Depression Among Type 2 Diabetes Patients in Taiwan.Frontiers in public health · 2021Article
- Performance of ICD-10-CM Diagnosis Codes for Identifying Acute Ischemic Stroke in a National Health Insurance Claims Database.Clinical epidemiology · 2020Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesA pay-for-performance (P4P) programme is a management strategy that encourages healthcare providers to deliver high quality of care. In Taiwan, the P4P programme has been implemented for diabetes, and certified diabetes physicians voluntarily enrol patients with diabetes into the P4P programme. The objectives of this study were to compare the risk of stroke and its related factors in patients with type 2 diabetes who were enrolled in a P4P programme compared with those who were not. STUDY
designThis study is a natural experiment in Taiwan. A retrospective cohort investigation was conducted from 2002 to 2013, which included 459 726 patients with type 2 diabetes, who were grouped according to P4P enrolment status following a propensity score matching process.
methodsWe reviewed patients ≥45 years of age newly diagnosed with type 2 diabetes mellitus (DM) from the National Health Insurance Research Database in Taiwan. A Cox proportional hazards model was used to compare the relative risk of stroke between patients with type 2 DM enrolled in the P4P programme and those who were not enrolled.
resultsCompared with the patients not enrolled, there was a significantly lower stroke risk in P4P participants (HR=0.97, 95% CI 0.95 to 0.99). Although a significantly lower risk of haemorrhagic stroke was observed (HR=0.87, 95% CI 0.82 to 0.93) in P4P participants, no statistically significant difference for the risk of ischaemic stroke between P4P and non-P4P patients (HR=0.99, 95% CI 0.97 to 1.02) was found. Following stratification analysis, a significantly reduced stroke risk was observed in male patients with type 2 diabetes, but not in women.
conclusionsParticipants in Taiwan's Diabetes P4P programme displayed a significantly reduced stroke risk, especially haemorrhagic stroke. We recommend the continual promotion of this programme to the general public and to physicians.
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