Does enhanced diabetes management reduce the risk and improve the outcome of tuberculosis?

H. Y. Lo, S. L. Yang, H. H. Lin, K. J. Bai, J. J. Lee, T. I. Lee, C. Y. Chiang

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

SETTING: The Bureau of National Health Insurance (NHI) has implemented a pay-for-performance (p4p) programme for diabetes mellitus (DM) in Taiwan. OBJECTIVE : To investigate whether patients with DM enrolled in the p4p programme (DM-p4p) are less likely to develop tuberculosis (TB) and whether they have a better outcome than patients with DMnot enrolled in the p4p programme (DM-non-p4p) if they do develop TB. DESIGN: A random sample of 79 471 DM-p4p, 100 000 DM-non-p4p and 100 000 non-diabetic patients (non-DM) was obtained from the 2008-2009 NHI database, and the patients were matched with the National TB Registry to determine whether they had developed TB by the end of 2010. RESULTS : The average annual incidence of TB was respectively 259.9 (95%CI 230.2-293.4), 137.5 (95%CI 116.4-162.5) and 74.1 (95%CI 59.0-93.0) per 100 000 population among DM-non-p4p, DM-p4p and non-DM patients. The relative risk of death over treatment success was 1.79 (95%CI 1.05-3.04) among DM-non-p4p and 1.69 (95%CI 0.84-3.40) among non-DM patients, relative to DM-p4p patients. CONCLUSIONS : Enhanced case management of DM reduced risk and improved outcomes of TB among patients with DM.

Original languageEnglish
Pages (from-to)376-382
Number of pages7
JournalInternational Journal of Tuberculosis and Lung Disease
Volume20
Issue number3
DOIs
Publication statusPublished - Mar 1 2016

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Risk Management
Diabetes Mellitus
Tuberculosis
National Health Programs
Incentive Reimbursement
Case Management
Taiwan
Registries
Databases
Incidence

Keywords

  • Glycaemic control
  • Outcome
  • Risk
  • Tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

Cite this

Does enhanced diabetes management reduce the risk and improve the outcome of tuberculosis? / Lo, H. Y.; Yang, S. L.; Lin, H. H.; Bai, K. J.; Lee, J. J.; Lee, T. I.; Chiang, C. Y.

In: International Journal of Tuberculosis and Lung Disease, Vol. 20, No. 3, 01.03.2016, p. 376-382.

Research output: Contribution to journalArticle

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abstract = "SETTING: The Bureau of National Health Insurance (NHI) has implemented a pay-for-performance (p4p) programme for diabetes mellitus (DM) in Taiwan. OBJECTIVE : To investigate whether patients with DM enrolled in the p4p programme (DM-p4p) are less likely to develop tuberculosis (TB) and whether they have a better outcome than patients with DMnot enrolled in the p4p programme (DM-non-p4p) if they do develop TB. DESIGN: A random sample of 79 471 DM-p4p, 100 000 DM-non-p4p and 100 000 non-diabetic patients (non-DM) was obtained from the 2008-2009 NHI database, and the patients were matched with the National TB Registry to determine whether they had developed TB by the end of 2010. RESULTS : The average annual incidence of TB was respectively 259.9 (95{\%}CI 230.2-293.4), 137.5 (95{\%}CI 116.4-162.5) and 74.1 (95{\%}CI 59.0-93.0) per 100 000 population among DM-non-p4p, DM-p4p and non-DM patients. The relative risk of death over treatment success was 1.79 (95{\%}CI 1.05-3.04) among DM-non-p4p and 1.69 (95{\%}CI 0.84-3.40) among non-DM patients, relative to DM-p4p patients. CONCLUSIONS : Enhanced case management of DM reduced risk and improved outcomes of TB among patients with DM.",
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