title: Does Pay-For-Performance Program Increase Providers Adherence to Guidelines for Managing Hepatitis B and Hepatitis C Virus Infection in Taiwan?
abstract: BACKGROUND
  Many people are concerned about that the quality of preventive care for patients with hepatitis B virus (HBV) and hepatitis C virus (HCV) infection is suboptimal. Taiwan, a hyperendemic area of chronic HBV and HCV infection, implemented a nationwide pay-for-performance (P4P) program in 2010, which aimed to improve the preventive care provided to HBV and HCV patients by increasing physicians' adherence to guidelines through financial incentives. The objective of this study was to evaluate the early effects of the P4P program on utilization of preventive services by HBV and HCV patients.
  
  
  METHODS
  Using a quasi-experimental design with propensity score matching method, we matched the HBV and HCV patients enrolled in the P4P program with non-enrollees in 2010, resulting in 21,643 patients in each group. Generalized estimating equations was applied to examine the difference-in-difference effects of P4P program enrollment on the utilization of three guideline-recommended preventive services (regular outpatient follow-up visits, abdominal ultrasonography (US) examinations, and aspartate aminotransferase and alanine aminotransferase (AST/ALT) tests by HBV and HCV patients.
  
  
  RESULTS
  The P4P program enrollees were significantly more likely to attend twice-annual follow-up visits, to receive recommended US examinations and AST/ALT tests, than non-enrollees.
  
  
  CONCLUSIONS
  The results of our preliminary assessment indicate that financial incentives offered by the P4P program was associated with a modest improvement in adherence to guidelines for better chronic HBV and HBC management.
authors: Institute of Hospital Health Care Administration, National Yang Ming University, Taipei, Taiwan.|National Health Insurance Administration, Ministry of Health and Welfare, Taipei, Taiwan.
authors: Huei-Ju
authors: HJ
authors: Chen
authors: Institute of Hospital Health Care Administration, National Yang Ming University, Taipei, Taiwan.
authors: Nicole
authors: N
authors: Huang
authors: Health Promotion Administration, Ministry of Health and Welfare, Taipei, Taiwan.
authors: Long-Sheng
authors: LS
authors: Chen
authors: Institute of Public Health, National Yang Ming University, Taipei, Taiwan.
authors: Yiing-Jenq
authors: YJ
authors: Chou
authors: Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.|School of Medicine, National Yang Ming University, Taipei, Taiwan.
authors: Chung-Pin
authors: CP
authors: Li
authors: School of Medicine, National Yang Ming University, Taipei, Taiwan.|Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Chen-Yi
authors: CY
authors: Wu
authors: Department of Healthcare Administration, Asia University, Taichung, Taiwan.|Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan.
authors: Yu-Chia
authors: YC
authors: Chang
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000378:metabolism; D001219:Aspartate Aminotransferases / Q000378:metabolism; D005260:Female; D019983:Guideline Adherence / Q000191:economics*; D006282:Health Personnel / Q000191:economics*; D006509:Hepatitis B / Q000191:economics* / Q000453:epidemiology / Q000378:metabolism / Q000517:prevention & control*; D006526:Hepatitis C / Q000191:economics* / Q000453:epidemiology / Q000378:metabolism / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012052:Reimbursement, Incentive / Q000706:statistics & numerical data*; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase