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

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. Intervention(s): 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 Measure(s): 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.