Increase in the pharmacological management of Type 2 diabetes with pay-for-performance in primary care in the UK

N. Gallagher*, C. Cardwell, C. Hughes, D. O'Reilly

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

Aims To determine whether the financial incentives for tight glycaemic control, introduced in the UK as part of a pay-for-performance scheme in 2004, increased the rate at which people with newly diagnosed Type 2 diabetes were started on anti-diabetic medication.

Methods A secondary analysis of data from the General Practice Research Database for the years 1999-2008 was performed using an interrupted time series analysis of the treatment patterns for people newly diagnosed with Type 2 diabetes (n=21 197).

Results Overall, the proportion of people with newly diagnosed diabetes managed without medication 12months after diagnosis was 47% and after 24months it was 40%. The annual rate of initiation of pharmacological treatment within 12months of diagnosis was decreasing before the introduction of the pay-for-performance scheme by 1.2% per year (95% CI -2.0, -0.5%) and increased after the introduction of the scheme by 1.9% per year (95% CI 1.1, 2.7%). The equivalent figures for treatment within 24months of diagnosis were -1.4% (95% CI -2.1, -0.8%) before the scheme was introduced and 1.6% (95% CI 0.8, 2.3%) after the scheme was introduced.

Conclusion The present study suggests that the introduction of financial incentives in 2004 has effected a change in the management of people newly diagnosed with diabetes. We conclude that a greater proportion of people with newly diagnosed diabetes are being initiated on medication within 1 and 2years of diagnosis as a result of the introduction of financial incentives for tight glycaemic control.

Original languageEnglish
Pages (from-to)62-68
Number of pages7
JournalDiabetic Medicine
Volume32
Issue number1
Early online date15 Oct 2014
DOIs
Publication statusPublished - Jan 2015

Keywords

  • PRACTICE RESEARCH DATABASE
  • GENERAL-PRACTICE
  • INTERMEDIATE OUTCOMES
  • HEALTH-CARE
  • QUALITY
  • INCENTIVES
  • ENGLAND
  • ASSOCIATION
  • FRAMEWORK
  • PROVIDERS

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