TY - JOUR AU - Hsieh, Hui-Min AU - He, Jiun-Shiuan AU - Shin, Shyi-Jang AU - Chiu, Herng-Chia AU - Lee, Charles Tzu-Chi PY - 2017 TI - A Diabetes Pay-for-Performance Program and Risks of Cancer Incidence and Death in Patients With Type 2 Diabetes in Taiwan T2 - Preventing Chronic Disease JO - Prev Chronic Dis SP - E88 VL - 14 CY - Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. N2 - INTRODUCTION We sought to evaluate the effects of diabetes disease management through a diabetes pay-for-performance (P4P) program in Taiwan on risks of incident cancer and mortality among patients with type 2 diabetes. METHODS We conducted a longitudinal observational cohort study using 3 population-based databases in Taiwan. Using propensity score matching, we compared patients with type 2 diabetes who enrolled in a P4P program with a similar group of patients who did not enroll in the in P4P program (non-P4P). Primary end points of interest were risks of incident cancer and all-cause, cancer-specific, and diabetes-related mortality. Total person-years and incidence and mortality rates per 1,000 person-years were calculated. Multivariable Cox proportional hazard models and competing risk regression were used in the analysis. RESULTS Overall, our findings indicated that the diabetes P4P program was not significantly associated with lower risks of cancer incidence, but it was associated with lower risks of all-cause mortality (adjusted subdistribution hazard ratio [aSHR], 0.59; 95% confidence interval [CI], 0.55-0.63), cancer-specific mortality (aSHR, 0.85; 95% CI, 0.73-1.00), and diabetes-related mortality (aSHR, 0.54: 95% CI, 0.49-0.60). Metformin, thiazolidinediones, and alpha glucosidase inhibitors were associated with lower risks of cancer incidence and cancer-specific mortality. CONCLUSION Our findings provide evidence of the potential benefit of diabetes P4P programs in reducing risks of all-cause mortality and competing causes of death attributable to cancer-specific and diabetes-related mortality among type 2 diabetes patients. SN - 1545-1151 UR - https://doi.org/10.5888/pcd14.170012 DO - 10.5888/pcd14.170012 ER -