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

Infectious Diseases

Journal of AIDS & Clinical Research

Author(s): Gallagher N, Cardwell C, Hughes C, OReilly D, Gallagher N, Cardwell C, Hughes C, OReilly D

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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 12 months after diagnosis was 47\% and after 24 months it was 40\%. The annual rate of initiation of pharmacological treatment within 12 months 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 24 months 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 2 years of diagnosis as a result of the introduction of financial incentives for tight glycaemic control. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK. This article was published in Diabet Med and referenced in Journal of AIDS & Clinical Research

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