The impact of the diabetes management incentive on diabetes-related services: evidence from Ontario, Canada
- 1 December 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in The European Journal of Health Economics
- Vol. 21 (9), 1279-1293
- https://doi.org/10.1007/s10198-020-01216-6
Abstract
Financial incentives have been introduced in several countries to improve diabetes management. In Ontario, the most populous province in Canada, a Diabetes Management Incentive (DMI) was introduced to family physicians practicing in patient enrollment models in 2006. This paper examines the impact of the DMI on diabetes-related services provided to individuals with diabetes in Ontario. Longitudinal health administrative data were obtained for adults diagnosed with diabetes and their family physicians. The study population consisted of two groups: DMI group (patients enrolled with a family physician exposed to DMI for 3 years), and comparison group (patients affiliated with a family physician ineligible for DMI throughout the study period). Diabetes-related services was measured using the Diabetic Management Assessment (DMA) billing code claimed by patient's physician. The impact of DMI on diabetes-related services was assessed using difference-in-differences regression models. After adjusting for patient- and physician-level characteristics, patient fixed-effects and patient-specific time trend, we found that DMI increased the probability of having at least one DMA fee code claimed by patient's physician by 9.3% points, and the probability of having at least three DMA fee codes claimed by 2.1% points. Subgroup analyses revealed the impact of DMI was slightly larger in males compared to females. We found that Ontario's DMI was effective in increasing the diabetes-related services provided to patients diagnosed with diabetes in Ontario. Financial incentives for physicians help improve the provision of targeted diabetes-related services.Funding Information
- CIHR (MOP–130354)
This publication has 39 references indexed in Scilit:
- Disease-specific Pay-for-Performance ProgramsMedical Care, 2016
- Assessing the Effectiveness of Policies to Reduce Diabetes Hospitalizations Before and After the Reforms of Physician Payment and Primary Care Organization in British Columbia and AlbertaCanadian Journal of Diabetes, 2016
- Does pay-for-performance benefit patients with multiple chronic conditions? Evidence from a universal coverage health care systemHealth Policy and Planning, 2015
- Effect of a national primary care pay for performance scheme on emergency hospital admissions for ambulatory care sensitive conditions: controlled longitudinal studyBMJ, 2014
- LINK BETWEEN PAY FOR PERFORMANCE INCENTIVES AND PHYSICIAN PAYMENT MECHANISMS: EVIDENCE FROM THE DIABETES MANAGEMENT INCENTIVE IN ONTARIOHealth Economics, 2012
- A Longitudinal Examination of a Pay-for-Performance Program for Diabetes CareMedical Care, 2012
- Association of practice size and pay-for-performance incentives with the quality of diabetes management in primary careCMAJ : Canadian Medical Association Journal, 2011
- Does Higher Quality of Diabetes Management in Family Practice Reduce Unplanned Hospital Admissions?Health Services Research, 2010
- The effects of an incentive program on quality of care in diabetes managementHealth Economics, 2009
- Economic incentives in general practice: The impact of pay-for-participation and pay-for-compliance programs on diabetes careHealth Policy, 2009