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Participation and Outcomes among Disabled and Non-Disabled People in the Diabetes Pay-for-Performance Program
Objectives: This study’s objectives were to compare the participation rates of people with and without disabilities who had type 2 diabetes in a diabetes pay-for-performance (DM P4P) program, as well as their care outcomes after participation. Methods: This was a retrospective cohort study. The data...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10606631/ https://www.ncbi.nlm.nih.gov/pubmed/37893816 http://dx.doi.org/10.3390/healthcare11202742 |
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author | Kuo, Wei-Yin Tsai, Wen-Chen Kung, Pei-Tseng |
author_facet | Kuo, Wei-Yin Tsai, Wen-Chen Kung, Pei-Tseng |
author_sort | Kuo, Wei-Yin |
collection | PubMed |
description | Objectives: This study’s objectives were to compare the participation rates of people with and without disabilities who had type 2 diabetes in a diabetes pay-for-performance (DM P4P) program, as well as their care outcomes after participation. Methods: This was a retrospective cohort study. The data came from the disability registry file, cause of death file, and national health insurance research database of Taiwan. The subjects included patients newly diagnosed with type 2 diabetes between 2001 and 2013 who were followed up with until 2014 and categorized as disabled and non-disabled patients. The propensity score matching method was used to match the disabled with the non-disabled patients at a 1:1 ratio. Conditional logistic regression analysis was used to determine the odds ratio between the disabled and non-disabled patients who joined the P4P program. The Cox hazard model was used to compare the risk of dialysis and death between the disabled and non-disabled patients participating in the P4P program. Results: There were 110,645 disabled and 110,645 non-disabled individuals after matching. After controlling for confounding factors, it was found that the disabled individuals were significantly less likely (odds ratio = 0.89) to be enrolled in the P4P program than the non-disabled individuals. The risk of dialysis was 1.08 times higher for people with disabilities than those without, regardless of their participation in the P4P program. After enrollment in the P4P program, the risk of death for people with disabilities decreased from 1.32 to 1.16 times that of persons without disabilities. Among the people with disabilities, the risk of death for those enrolled in the P4P program was 0.41 times higher than that of those not enrolled. The risk of death was reduced to a greater extent for people with disabilities than for those without disabilities upon enrollment in the DM P4P program. Conclusion: People with disabilities are less likely to be enrolled in the P4P program in Taiwan and have unequal access to care. However, the P4P program was more effective at reducing mortality among people with disabilities than among those without. |
format | Online Article Text |
id | pubmed-10606631 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-106066312023-10-28 Participation and Outcomes among Disabled and Non-Disabled People in the Diabetes Pay-for-Performance Program Kuo, Wei-Yin Tsai, Wen-Chen Kung, Pei-Tseng Healthcare (Basel) Article Objectives: This study’s objectives were to compare the participation rates of people with and without disabilities who had type 2 diabetes in a diabetes pay-for-performance (DM P4P) program, as well as their care outcomes after participation. Methods: This was a retrospective cohort study. The data came from the disability registry file, cause of death file, and national health insurance research database of Taiwan. The subjects included patients newly diagnosed with type 2 diabetes between 2001 and 2013 who were followed up with until 2014 and categorized as disabled and non-disabled patients. The propensity score matching method was used to match the disabled with the non-disabled patients at a 1:1 ratio. Conditional logistic regression analysis was used to determine the odds ratio between the disabled and non-disabled patients who joined the P4P program. The Cox hazard model was used to compare the risk of dialysis and death between the disabled and non-disabled patients participating in the P4P program. Results: There were 110,645 disabled and 110,645 non-disabled individuals after matching. After controlling for confounding factors, it was found that the disabled individuals were significantly less likely (odds ratio = 0.89) to be enrolled in the P4P program than the non-disabled individuals. The risk of dialysis was 1.08 times higher for people with disabilities than those without, regardless of their participation in the P4P program. After enrollment in the P4P program, the risk of death for people with disabilities decreased from 1.32 to 1.16 times that of persons without disabilities. Among the people with disabilities, the risk of death for those enrolled in the P4P program was 0.41 times higher than that of those not enrolled. The risk of death was reduced to a greater extent for people with disabilities than for those without disabilities upon enrollment in the DM P4P program. Conclusion: People with disabilities are less likely to be enrolled in the P4P program in Taiwan and have unequal access to care. However, the P4P program was more effective at reducing mortality among people with disabilities than among those without. MDPI 2023-10-16 /pmc/articles/PMC10606631/ /pubmed/37893816 http://dx.doi.org/10.3390/healthcare11202742 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Kuo, Wei-Yin Tsai, Wen-Chen Kung, Pei-Tseng Participation and Outcomes among Disabled and Non-Disabled People in the Diabetes Pay-for-Performance Program |
title | Participation and Outcomes among Disabled and Non-Disabled People in the Diabetes Pay-for-Performance Program |
title_full | Participation and Outcomes among Disabled and Non-Disabled People in the Diabetes Pay-for-Performance Program |
title_fullStr | Participation and Outcomes among Disabled and Non-Disabled People in the Diabetes Pay-for-Performance Program |
title_full_unstemmed | Participation and Outcomes among Disabled and Non-Disabled People in the Diabetes Pay-for-Performance Program |
title_short | Participation and Outcomes among Disabled and Non-Disabled People in the Diabetes Pay-for-Performance Program |
title_sort | participation and outcomes among disabled and non-disabled people in the diabetes pay-for-performance program |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10606631/ https://www.ncbi.nlm.nih.gov/pubmed/37893816 http://dx.doi.org/10.3390/healthcare11202742 |
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