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. 2022 Apr 21:17:883-891.
doi: 10.2147/COPD.S349468. eCollection 2022.

The Impact of the Pay-for-Performance Program on the Outcome of COPD Patients in Taiwan After One Year

Kuo-Chen Cheng #  1 , Chih-Cheng Lai #  2 , Cheng-Yi Wang  3 , Ching-Min Wang  4 , Chung-Han Ho  5   6   7 , Mei-I Sung  1 , Shu-Chen Hsing  1 , Kuang-Ming Liao  8 , Shian-Chin Ko  1
Affiliations

The Impact of the Pay-for-Performance Program on the Outcome of COPD Patients in Taiwan After One Year

Kuo-Chen Cheng et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Objective: To investigate the impact of a multidisciplinary intervention on the clinical outcomes of patients with COPD.

Methods: This study retrospectively extracted the data of patients enrolled in the national pay-for-performance (P4P) program for COPD in four hospitals. Only COPD patients who received regular follow-up for at least one year in the P4P program between September 2018 and December 2020 were included.

Results: A total of 1081 patients were included in this study. Among them, 424 (39.2%), 287 (26.5%), 179 (16.6%), and 191 (17.7%) patients were classified as COPD Groups A, B, C, and D, respectively. Dual therapy with long-acting β2-agonist (LABA)/long-acting muscarinic antagonist (LAMA) was the most used inhaled bronchodilator at baseline (n = 477, 44.1%) patients, followed by LAMA monotherapy (n = 195, 18.0%), triple therapy with inhaled corticosteroid (ICS)/LABA/LAMA (n = 184, 17.0%), and ICS/LABA combination (n = 165, 15.3%). After one year of intervention, 374 (34.6%) and 323 (29.9%) patients had their pre- and post-bronchodilator-forced expiratory volume in one second (FEV1) increase of more than 100 mL. Both the COPD Assessment Test (CAT) and modified British Medical Research Council (mMRC) scores had a mean change of -2.2 ± 5.5 and -0.3 ± 0.9, respectively. The improvement in pulmonary function and symptom score were observed across four groups. The decreased number of exacerbations was only observed in Groups C and D, and not in Groups A and B.

Conclusion: This real-world study demonstrated that the intervention in the P4P program could help improve the clinical outcome of COPD patients. It also showed us a different view on the use of dual therapy, which has a lower cost in Taiwan.

Keywords: COPD; DSC-COPD; Disease-Specific Care – Chronic Obstructive Pulmonary Disease; Joint Commission of Taiwan; certification program; chronic obstructive pulmonary disease; dual therapy; pay-for-performance; quality-improvement.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The distribution of 1081 patients with COPD according to GOLD grade.
Figure 2
Figure 2
Inhaled bronchodilator uses according to COPD group.
See this image and copyright information in PMC

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