1. Measuring Preferences for a Diabetes Pay-for-Performance for Patient (P4P4P) Program using a Discrete Choice Experiment
- Author
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Ya Seng Hsueh, Tsung Tai Chen, Kay Lun Li, Tao Hsin Tung, Hsiu Mei Liang, Chao Hsiun Tang, Kuo-Piao Chung, and Ming Han Tsai
- Subjects
Male ,Financing, Personal ,Health Knowledge, Attitudes, Practice ,Time Factors ,Patients ,Taiwan ,Pay for performance ,Choice Behavior ,Multivariate probit model ,Reward ,willingness to accept ,Willingness to pay ,Risk Factors ,Surveys and Questionnaires ,Diabetes Mellitus ,Humans ,Medicine ,Program Development ,Patient participation ,Exercise ,Reimbursement, Incentive ,Aged ,Actuarial science ,diabetes ,business.industry ,Health Policy ,discrete choice experiment ,Public Health, Environmental and Occupational Health ,Patient Preference ,Middle Aged ,medicine.disease ,Comorbidity ,Diet ,Incentive ,Sample size determination ,Health Care Surveys ,Female ,Patient Participation ,Willingness to accept ,pay-for-performance for patient (P4P4P) ,business ,Risk Reduction Behavior ,Demography - Abstract
Objective To elicit a patient's willingness to participate in a diabetes pay-for-performance for patient (P4P4P) program using a discrete choice experiment method. Methods The survey was conducted in March 2013. Our sample was drawn from patients with diabetes at five hospitals in Taiwan ( International Classification of Diseases, Ninth Revision, Clinical Modification code 250). The sample size was 838 patients. The discrete choice experiment questionnaire included the attributes monthly cash rewards, exercise time, diet control, and program duration. We estimated a bivariate probit model to derive willingness-to-accept levels after accounting for the characteristics (e.g., severity and comorbidity) of patients with diabetes. Results The preferred program was a 3-year program involving 30 minutes of exercise per day and flexible diet control. Offering an incentive of approximately US $67 in cash per month appears to increase the likelihood that patients with diabetes will participate in the preferred P4P4P program by approximately 50%. Conclusions Patients with more disadvantageous characteristics (e.g., elderly, low income, greater comorbidity, and severity) could have less to gain from participating in the program and thus require a higher monetary incentive to compensate for the disutility caused by participating in the program's activities. Our result demonstrates that a modest financial incentive could increase the likelihood of program participation after accounting for the attributes of the P4P4P program and patients' characteristics.
- Published
- 2015
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