We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Influence of a pay-for-performance program on the care of diabetic patients by family physicians in New Brunswick.
- Authors
LeBlanc, E.; Bélanger, M.; Thibault, V.; Babin, L.; Greene, B.; Halpine, S.; Mancuso, M.
- Abstract
Introduction: With increasing costs associated with diabetes management, many jurisdictions are using pay-for-performance programs to entice family physicians to follow practice guidelines when caring for their diabetic patients. The impact of such programs on the health of patients is unknown. Objective: The objective of this study was to determine whether hemoglobin A1C (A1C) of diabetic patients was improved following the introduction of an incentive program in New Brunswick in 2010. Two outcomes were considered: the probability of having had at least two A1C tests per year and the mean A1C of patients. Methods: Administrative data from all diabetic patients (n = 83 580) with A1C tests were acquired from the New Brunswick Department of Health and patients' respective fee-for-service family physicians (n = 583). Both repeat-cross-sectional and cohortbased (2005-2014) analyses were conducted. Patients were divided in two groups depending on whether their family physician had claimed the incentive or not. Multivariate analyses were conducted to compare pre- and post-incentive period for probability of having had two tests per year (logistic) and mean A1C (linear). The same outcomes were compared between patients for whom an incentive was claimed and those for whom it was not claimed after 2010. Results: Family physicians who were already prescribing at least two A1C tests per year before the implementation of the incentive program had 51% greater odds than other physicians to continue to do so after the implementation (99% CI: 1.44-1.57). Patients followed by a family physician claiming the incentive had 33% greater odds of receiving at least two A1C tests per year (99% CI: 1.24-1.43). However, there were no differences in annual A1C means between sub-groups studied. Conclusion: This analysis suggests that implementation of an incentive program led physicians to provide better follow-up care to patients with diabetes. However, the incentive program has not been associated with differences in glycemic control. These results suggest that although incentive programs may help physicians provide better care to their patients with diabetes, these programs may not be sufficient to result in optimal glycemic control. Further analyses are needed to confirm these results, to estimate the combined effects of incentive programs with other interventions and to assess the cost-benefit of such interventions.
- Subjects
VALUE-based healthcare; PEOPLE with diabetes; PHYSICIANS; LABOR incentives; GLYCEMIC control
- Publication
Health Promotion & Chronic Disease Prevention in Canada, 2016, Vol 36, Issue 11, p269
- ISSN
2368-738X
- Publication type
Article