Paper Title
The Impact of Pay-For-Performance Program on Healthcare Expenditure of Patients with Diabetes in Taiwan - A Population based Study

Abstract
Diabetes is one of the leading causes of death in Taiwan which often requires integrated care from multiple medical specialties. Thus, pay-for-performance (PFP) program under National Health Insurance is considered to be a superior way to incentivize providers to give comprehensive care to the patients. This research analyzes to what extend that patients enrolled in the PFP program can achieve cost saving controlling demographic and disease severity level. Annual incidences of hospitalization for diabetic patients are calculated from data of the National Health Insurance Research Database (NHIRD).Randomly selected patients were extract facilitated by propensity score matching between PFP enrollees and non-enrollees. Monthly hospitalization days for each patients as well as health expenditure from claim dataare submitted to intervention analyses using ANOVA, panel regression, general least square methodin order to access the overall effect of PFP program. The empirical findings suggest that PFP enrollees tend to have shorter stay in hospitals, lower spending, and are more sever in terms of disease comorbidity condition. Age is not significantly different between these two groups of patients. The effects of PFP on inpatient days persist when controlling comorbidity, income, geographic, and yearly fixed effects. Patients with more sever comorbidity condition, higher income level, and female are associated with longer inpatient hospital stay and greater hospital spending. Older patients tend to have fewer hospital stay but greater hospital expenditure than younger patients. PFP program is clearly associated with shorter inpatient hospital days. The result of this research can be of important policy implication for health care authorities in the future. Keywords - Propensity score matching, pay-for-performance program, panel study