Effects of pay-for-performance system on tuberculosis default cases control and treatment in Taiwan

Summary Objectives In order to make tuberculosis (TB) treatment more effective and to lower the default rate of the disease, the Bureau of National Health Insurance (BNHI) in Taiwan implemented the “pay-for-performance on Tuberculosis” program (P4P on TB) in 2004. The purpose of this study is to investigate the effectiveness of the P4P system in terms of default rate. Methods This is a retrospective study. National Health Insurance Research Datasets in Taiwan from 2002 to 2005 has been used for the study. The study compared the differences of TB default rate before and after the implementation of P4P program, between participating and non-participating hospitals, and between P4P hospitals with and without case managers. Furthermore, logistic regression analysis was conducted to explore the related factors influencing TB patients default treatment after TB detected. Results The treatment default rate after “P4P on TB” was 11.37% compared with the 15.56% before “P4P on TB” implementation. The treatment default rate in P4P hospitals was 10.67% compared to 12.7% in non-P4P hospitals. In addition, the default rate was 10.4% in hospitals with case managers compared with 12.68% in hospitals without case managers. Conclusions The results of the study showed that “P4P on TB” program improved the treatment default rate for TB patients. In addition, case managers improved the treatment outcome in controlling patients’ default rate.

[1]  D. Snider,et al.  Enhancing patient compliance with tuberculosis therapy. , 1989, Clinics in chest medicine.

[2]  M. Raviglione,et al.  Tuberculosis control in Europe and international migration. , 1994, The European respiratory journal.

[3]  V. Diwan,et al.  Staff and patient attitudes to tuberculosis and compliance with treatment: an exploratory study in a district in Vietnam. , 1996, Tubercle and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[4]  M. Nichter.  Illness semantics and international health: the weak lungs/TB complex in the Philippines. , 1994, Social science & medicine.

[5]  M. Colledge.  Migration and Health: Towards an Understanding of the Health Care Needs of Ethnic Minorities. Proceedings of a Consultative Group on Ethnic Minorities (The Hague, Netherlands, November 28-30, 1983). , 1986 .

[6]  H. Adriaanse,et al.  In search of factors responsible for noncompliance among tuberculosis patients in Wardha District, India. , 1992, Social science & medicine.

[7]  E. Sumartojo.  When tuberculosis treatment fails. A social behavioral account of patient adherence. , 1993, The American review of respiratory disease.

[8]  P. Davies.  Tuberculosis and Migration , 1995, Journal of the Royal College of Physicians of London.

[9]  C. Mackenzie,et al.  A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. , 1987, Journal of chronic diseases.

[10]  C. Liam,et al.  Attitudes and knowledge of newly diagnosed tuberculosis patients regarding the disease, and factors affecting treatment compliance. , 1999, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[11]  J. Porter,et al.  Adherence to tuberculosis treatment: lessons from the urban setting of Delhi, India , 2003, Tropical medicine & international health : TM & IH.

[12]  D. Weil,et al.  Worldwide: Incentives for tuberculosis diagnosis and treatment. , 2009 .

[13]  P. R. Narayanan,et al.  Reasons for non-compliance among patients treated under Revised National Tuberculosis Control Programme (RNTCP), Tiruvallur district, south India. , 2007, The Indian journal of tuberculosis.

[14]  P. Revsbech,et al.  [Tuberculosis and migration]. , 1999, Ugeskrift for laeger.

[15]  J. Sbarbaro.  Compliance: inducements and enforcements. , 1979, Chest.

[16]  B. Lindtjørn,et al.  Determinants of Treatment Adherence Among Smear-Positive Pulmonary Tuberculosis Patients in Southern Ethiopia , 2005, Genome Biology.

[17]  Dodor Ea.  Tuberculosis treatment default at the communicable diseases unit of Effia-Nkwanta Regional Hospital: a 2-year experience. , 2004 .

[18]  J. Walley,et al.  Tuberculosis in Pakistan: socio-cultural constraints and opportunities in treatment. , 2000, Social science & medicine.

[19]  Karen Brudney,et al.  Resurgent Tuberculosis in New York City: Human Immunodeficiency Virus, Homelessness, and the Decline of Tuberculosis Control Programs , 1991, The American review of respiratory disease.

[20]  J. Caylà,et al.  Current status of treatment completion and fatality among tuberculosis patients in Spain. , 2004, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[21]  Snider De,et al.  Enhancing patient compliance with tuberculosis therapy. , 1989, Clinics in chest medicine.

[22]  T M Comolet,et al.  Factors determining compliance with tuberculosis treatment in an urban environment, Tamatave, Madagascar. , 1998, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[23]  J. Goldman,et al.  The association of age with the presentation and outcome of tuberculosis: a five-year survey. , 1993, Age and ageing.

[24]  Y. G. Shrikhandé.  Indian Journal of Tuberculosis , 1931, The Indian medical gazette.

[25]  Emmanuel Atsu Dodor.  Tuberculosis treatment default at the communicable diseases unit of Effia-Nkwanta Regional Hospital: a 2-year experience. , 2004, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[26]  V. Diwan,et al.  Attitudes to compliance with tuberculosis treatment among women and men in Vietnam. , 1999, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[27]  M. S. al-Hajjaj,et al.  High rate of non-compliance with anti-tuberculosis treatment despite a retrieval system: a call for implementation of directly observed therapy in Saudi Arabia. , 2000, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[28]  A. Parsyan,et al.  Predictors of failure to complete treatment for latent tuberculosis infection. , 2007, The Journal of infection.

[29]  Anthony D. Harries,et al.  Treatment of tuberculosis: guidelines for national programmes. Second edition. , 1997 .

[30]  B. Lindtjørn,et al.  Community tuberculosis care through "TB clubs" in rural North Ethiopia. , 2003, Social science & medicine.

[31]  C. Chee,et al.  Patient and disease characteristics, and outcome of treatment defaulters from the Singapore TB control unit--a one-year retrospective survey. , 2000, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[32]  G. Afenyadu,et al.  Factors associated with tuberculosis treatment default and completion at the Effia-Nkwanta Regional Hospital in Ghana. , 2005, Transactions of the Royal Society of Tropical Medicine and Hygiene.