Effects of Body Mass Index and Pay-for-Performance Program on Risk of Death in Patients with Type 2 Diabetes: A Nationwide Cohort Study.
Int J Environ Res Public Health
; 18(9)2021 04 27.
Article
em En
| MEDLINE
| ID: mdl-33925667
ABSTRACT
BACKGROUND:
The diabetes patients enrolled in the pay-for-performance (P4P) program demonstrate reduced risk of death. Body mass index (BMI) is a risk factor of all-cause death. This study investigates the effects of BMI and P4P on the risk of death in type 2 diabetes patients.METHODS:
This is a retrospective cohort study. The study population includes the 3-wave National Health Interview Survey in Taiwan. A total of 6354 patients with diabetes aged ≥ 20 years were enrolled and followed up until the end of 2014.RESULTS:
The highest mortality rate per 1000 person-years was 61.05 in the underweight patients with diabetes. A lower crude death rate was observed in the P4P participants than non-P4P participants. The risk of death was 1.86 times higher in the underweight patients with diabetes than that in the normal weight group (95% CI 1.37-2.53) and was lower in the P4P participants, as compared to the non-participants (HR 0.55, 95% CI 0.44-0.69). The most significant effect of joining the P4P program in reducing death risk was found in the underweight patients with diabetes (HR 0.11, 95% CI 0.04-0.38), followed by the obesity group (HR 0.30, 95% CI 0.17-0.52).CONCLUSIONS:
Different effects of joining the P4P program on reducing death risk were observed in the underweight and obesity groups. We strongly recommend that patients with diabetes and without healthy BMIs participate in the P4P program.Palavras-chave
Texto completo:
1
Temas:
ECOS
/
Aspectos_gerais
Bases de dados:
MEDLINE
Assunto principal:
Reembolso de Incentivo
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Diabetes Mellitus Tipo 2
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Risk_factors_studies
Limite:
Adult
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Humans
País/Região como assunto:
Asia
Idioma:
En
Revista:
Int J Environ Res Public Health
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Taiwan