The Impact of Pay-for-Performance Program on the Medical Utilization of Type 2 Diabetes in Taiwan

• Main Authors: Chia-Wen Hou, 侯佳雯
• Other Authors: 薛亞聖
• Format: Others
• Language: zh-TW
• Published: 2005
• Online Access: http://ndltd.ncl.edu.tw/handle/15612053582436602999

碩士 === 國立臺灣大學 === 醫療機構管理研究所 === 93 === Pay-for-Performance Program has been put into practice since September 1, 2001. The program was designed to reduce the expenditure growth of diabetes mellitus and control diabetes by providing complete care for diabetics. The purpose of this research was to evaluate the impact of Pay-for-Performance Program on the medical utilization of type 2 diabetes in Taiwan. This study observed type 2 diabetics’ medical utilization for two years before and after the introduction of Pay-for-Performance Program. It was a case-control study. The study group were the type 2 diabetics who were the participators of the Pay-for-Performance Program, and the control group were the type 2 diabetics who were not the participators of the Pay-for-Performance Program. Besides, in order to avoid selection bias, there was a compare group. The compare group were the type 2 diabetics who receive medical care for diabetes at the hospitals didn`t participate the Pay-for-Performance Program. This study used claimed data of Nation Health Insurance and Department of Health from 2001 to 2002 for analysis. The ‘‘difference-in diffenence’’ methodology and polynomial regression were used for statistic analysis. The main findings of this study were concluded as below: 1. The impacts of type 2diabetics medical utilization: (1) After Pay-for-Performance Program was put into practice, the rates of the study group to accept the annual seven necessary examines increased. (2) Compared to the control group and compare group, the study group had a significant increase on ambulatory care visits. (3) Compared to the control group, the study group had a significant decrease on emergency care visits, but had a significant increase when comparing to the compare group. (4) Compared to the control group, the study group had a significant decrease on length of stay, but there was no significant effect between the study group and the compare group. 2. The impacts of diabetics medical expenditure: (1) Compared to the control group and compare group, the study group had a significant decrease on ambulatory expenditure, emergency expenditure, hospitalization expenditure, and total medical expenses. This study found the study group decreased the total medical expenses, and increased the rates of the study group to accept the annual seven necessary examines under the Pay-for-Performance Program. Therefore, this study suggests: 1. It is appropriate to maintain the current Pay-for-Performance Program. 2. All of the type 2 diabetics can be included to the Pay-for-Performance Program, and receive complete care for diabetes.