The impact of the diabetes management incentive on diabetes-related services: evidence from Ontario, Canada
- PDF / 1,191,329 Bytes
- 15 Pages / 595.276 x 790.866 pts Page_size
- 85 Downloads / 189 Views
ORIGINAL PAPER
The impact of the diabetes management incentive on diabetes‑related services: evidence from Ontario, Canada Thaksha Thavam1 · Rose Anne Devlin2 · Amardeep Thind1 · Gregory S. Zaric1,3 · Sisira Sarma1,4 Received: 16 January 2020 / Accepted: 25 June 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
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. Keywords Diabetes management · Financial incentive · Primary care physician · Ontario · Canada JEL Classification I10 · I12 · I18 · C23 · C33
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10198-020-01216-6) contains supplementary material, which is available to authorized users.
The number of individuals living with diabetes worldwide has increased from 108 million in 1980 to approximately 422 million in 2014 [1]. In Canada, over 2.2 million individuals aged 12 and over lived with diabetes in 2017, of which 965,100 were from Ontario, the most populous province in 1
Thaksha Thavam [email protected]
Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON N6A 5C1, Canada
2
Rose Anne Devlin [email protected]
Department of Economics, University of Ottawa, Ottawa, ON, Canada
3
Amardeep Thind [email protected]
Ivey School of Business, University of Western Ontario, London, ON, Canada
4
ICES, T
Data Loading...
