Effect of the pay-for-performance program for breast cancer care in Taiwan
Journal
Journal of Oncology Practice
Journal Volume
7
Journal Issue
3 SUPPL.
Date Issued
2011
Author(s)
Abstract
Purpose: To evaluate the impact of the nationwide pay-for-performance (P4P) program for breast cancer care (BC-P4P) in Taiwan on care quality, patient survival, and recurrence. Study Design: A population-based observational study with cross-sectional design. Methods: Retrospective analysis of population-based cancer registration and claims data was used in this study. A total of 4,528 patients with stage I or II breast cancer diagnosed in 2002 or 2003 who received curative surgery were observed until the end of 2008. This study applied multivariate linear regression to explore the association between BC-P4P enrollment and quality of care. Cox regression was applied to examine the effect of BC-P4P enrollment on 5-year recurrence and overall survival among patients with breast cancer. Results: After controlling for age, stage, type of surgery, and other factors, BC-P4P enrollees were found to have received better quality care than nonenrollees (P = .001). Cox regression models also indicated that after controlling for patient characteristics, quality of care was related to better 5-year overall survival (odds ratio [OR], 0.212; P = .001) and recurrence (OR, 0.289; P < .001). Even when controlled by quality of care provided to patients and its interaction with status of BC-P4P enrollment, BC-P4P enrollment remained statistically significant regarding 5-year overall survival (OR, 0.167; P < .001) and recurrence (OR, 0.370; P = .002). Conclusion: Patients with breast cancer enrolled in the BC-P4P program received better quality care and had better outcome than nonenrolled patients. Evidence from this study indicates that financial incentives in the payment design had a positive impact on outcome of breast cancer care. Copyright ? 2011 by American Society of Clinical Oncology and Managed Care & Healthcare Communications, LLC.
SDGs
Other Subjects
adult; article; breast cancer; cancer patient; cancer recurrence; cancer survival; controlled study; cross-sectional study; disease severity; female; health care quality; health program; human; major clinical study; multiple linear regression analysis; observational study; overall survival; pay for performance program; proportional hazards model; Taiwan
Type
journal article