Differences in patient reports on the quality of care in a diabetes pay-for-performance program between 1 year enrolled and newly enrolled patients.

ABSTRACT

OBJECTIVE: This study aimed to assess the quality of care from the perspective of patients who participated in the diabetes pay-for-performance (P4P) program in Taiwan. DESIGN: A cross-sectional telephone interview to measure the quality of care for patients with diabetes mellitus. SETTING: A stratified sampling according to the level and region of the health-care providers in Taiwan. PARTICIPANTS: A total of 1796 patients with diabetes mellitus responded to the telephone survey. INTERVENTIONS: The patients were divided into two groups according to the length of time they had participated in the program (1) the case group, who had received comprehensive care for at least 1 year and (2) the control group, who were newly enrolled in the diabetes mellitus P4P program for <3 months. MAIN OUTCOME MEASURES: The compliance of diabetes self-care and the level of satisfaction with the quality of care from the perspective of the patients. RESULTS: After controlling for the characteristics of the health-care providers involved, pattern of diabetes treatment, self-reported health status and other patient characteristics, the case group performed better in exercise, had regular medication and better foot care and showed overall compliance with diabetes self-care and perceived better quality of care than the control group. CONCLUSIONS: The patients who had received comprehensive care for 1 year showed better compliance with self-care and were more satisfied with the quality of care they had received. The P4P program appears to be associated with this enhanced care.