250549 Economic Evaluation of pay-for-performance program for diabetes in Taiwan

Monday, October 31, 2011: 1:06 PM

Elise C. Tan , Institute of Health Policy and Management, National Taiwan University, Taipei City, Taiwan
Ming Chin Yang, PhD , Institute of Health Policy and Management, National Taiwan University, Taipei City, Taiwan
Duan-Rung Chen, PhD , College of Public Health, National Taiwan University, Taipei City, Taiwan
A pay for performance (P4P) program for diabetes were implemented in Taiwan from 2001. However, there exist only limited information concerning whether the P4P program affects patient's health-related quality of life. The aim of this study was to estimate the cost and consequences of patients enrolled in the P4P program. A retrospective observational study of 522 diabetic patients was conducted from 2004 to 2005. The data used in the study was from the National Health Interview Survey (NHIS). Direct cost data were obtained from NHI claim files. SF36 health module was employed to measure health-related quality-of-life and transform to utility index. Patients enrolled in the P4P program at least six months were identified as P4P patients. After propensity score matching, a total of 422 (80.9%) patients were included in the study. A single-payer perspective was assumed and cost was expressed in 2005 US dollars. Patient's age, gender, education, family income, smoking status, BMI and insulin user were not significantly different between two groups. The P4P group had an increase of 1.03 month of life at an additional cost of $111.3, thus yielding the ICER of $1083.5 per life month. The P4P group had an increase of 0.55 quality-adjust life months at an addition cost of $111.3, thus the ICER of $2015.0 per QALY. The diabetic P4P program may result in gains in both life months and quality-adjust life months. According to commonly used ICER threshold of US$50,000 per QALY, the preliminary results showed that diabetic P4P program was very cost-effective.

Learning Areas:
Administration, management, leadership
Biostatistics, economics
Chronic disease management and prevention
Program planning
Provision of health care to the public
Public health or related research

Learning Objectives:
Compare cost and consequence of diabetic pay-for-performance program.

Keywords: Outcomes Research, Diabetes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be an abstract Author on the content I am responsible for data analysis, literature collection and writing abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.