Chronic care model in the diabetes pay-for-performance program in Taiwan:Benefits,challenges and future directions

作     者：Tsung-Tai Chen Brian Oldenburg Ya-Seng Hsueh 

作者机构：Department of Public HealthCollege of MedicineFu Jen Catholic UniversityNew Taipei 24205Taiwan Noncommunicable Disease Control UnitMelbourne School of Population and Global HealthUniversity of MelbourneMelbourne 3053Australia Centre for Health PolicyMelbourne School of Population and Global HealthUniversity of MelbourneMelbourne 3053Australia 

出 版 物：《World Journal of Diabetes》 (世界糖尿病杂志（英文版）（电子版）)

年 卷 期：2021年第12卷第5期

页      面：578-589页

核心收录：

学科分类：1002[医学-临床医学] 1011[医学-护理学（可授医学、理学学位）] 10[医学] 

基　　金：Ministry of Science and Technology in Taipei No.106-2918-I-030-002. 

主　　题：Chronic care model Diabetes Pay-for-performance Shared care Diabetes care 

摘      要：In this review,we discuss the chronic care model(CCM)in relation to the diabetes pay-for-performance(P4P)program in Taiwan.We first introduce the 6 components of the CCM and provide a detailed description of each of the activities in the P4P program implemented in Taiwan,mapping them onto the 6 components of the CCM.For each CCM component,the following three topics are described:the definition of the CCM component,the general activities implemented related to this component,and practical and empirical practices based on hospital or local government cases.We then conclude by describing the possible successful features of this P4P program and its challenges and future directions.We conclude that the successful characteristics of this P4P program in Taiwan include its focus on extrinsic and intrinsic incentives(i.e.,shared care network),physician-led P4P and the implementation of activities based on the CCM components.However,due to the low rate of P4P program coverage,approximately 50%of patients with diabetes cannot enjoy the benefits of CCMrelated activities or receive necessary examinations.In addition,most of these CCM-related activities are not allotted an adequate amount of incentives,and these activities are mainly implemented in hospitals,which compared with primary care providers,are unable to execute these activities flexibly.All of these issues,as well as insufficient implementation of the e-CCM model,could hinder the advanced improvement of diabetes care in Taiwan.