Table 3

The effect of the P4P programme on incidence risks of haemorrhagic stroke and ischaemic stroke in patients with type 2 diabetes

nHaemorrhagic strokeIschaemic stroke
n1 HR95% CIP value*n2 HR95% CIP value*
P4P participating status
 Non-P4P (ref)228 170215811 588
 P4P228 17019190.870.820.93<0.00111 9080.990.97 to 1.020.632
Gender
 Female (ref)228 178169810 518
 Male228 16223791.551.461.65<0.00112 9781.431.39 to 1.47<0.001
Patient’s age (years)
 45–54 (ref)138 8679533907
 55–64159 35712151.181.081.28<0.00168991.611.54 to 1.67<0.001
 65–74107 66611881.621.481.77<0.00179962.632.52 to 2.73<0.001
 ≥7550 4507212.382.142.65<0.00146943.803.63 to 3.98<0.001
Monthly salary (US$)
 ≤55723 8232451240
 557–735202 64020960.930.821.070.32112 2591.010.95 to 1.070.863
 735–929107 1109160.810.700.930.00355210.910.86 to 0.970.003
 929–117140 0622630.790.660.940.00814090.840.78 to 0.90<0.001
 1171–147741 8642760.700.590.83<0.00115970.800.75 to 0.87<0.001
 ≥147740 8412810.670.560.79<0.00114700.690.64 to 0.74<0.001
Urbanisation of residence area
 Level 1 (ref)124 28110055204
 Level 2142 07211841.000.911.080.90367651.101.06 to 1.14<0.001
 Level 368 9296041.000.901.100.92037541.181.13 to 1.23<0.001
 Level 470 3117251.100.991.210.06543961.251.20 to 1.30<0.001
 Level 511 4611271.080.901.310.4107391.161.08 to 1.26<0.001
 Level 620 9272671.311.141.50<0.00114881.351.27 to 1.43<0.001
 Level 718 3591650.930.781.100.38611501.211.13 to 1.29<0.001
CCI score
 0 (ref)288 669224813 386
 1105 51410531.131.051.210.00260501.010.98 to 1.040.476
 ≥262 1577761.301.191.42<0.00140601.020.98 to 1.060.282
DCSI score
 0 (ref)361 809300417 077
 159 9005711.030.941.130.50035791.101.06 to 1.14<0.001
 ≥234 6315021.411.281.56<0.00128401.391.34 to 1.45<0.001
Level of the healthcare organisation
 Medical centre81 8456070.920.831.020.12035180.890.85 to 0.92<0.001
 Regional153 17914081.121.031.210.00877901.020.99 to 1.060.187
 District92 1369711.161.061.260.00153921.030.99 to 1.070.099
 Clinic (ref)129 18010916796
Ownership of organisation
 Public (ref)106 9069375426
 Non-public349 43431401.101.021.180.01618 0701.121.09 to 1.16<0.001
Main physician is an endocrinologist
 No (ref)379 138353420 366
 Yes77 2025430.870.790.950.00331300.910.88 to 0.95<0.001
Physician’s annual service volume
 Low (ref)673269362
 Medium49 0614981.060.821.370.65127051.131.01 to 1.260.035
 High400 54735100.980.771.250.85420 4291.070.96 to 1.180.245
Use of adult health check
 No (ref)200 80516648481
 Yes255 53524130.840.780.90<0.00115 0150.920.89 to 0.95<0.001
Duration of DM (years)
 <3 (ref)252 506211811 342
 3–6118 16812381.101.021.180.01376211.211.17 to 1.24<0.001
 6–961 1215971.191.091.31<0.00136051.271.22 to 1.32<0.001
 ≥924 5451240.890.741.070.2219281.191.11 to 1.28<0.001
  • *Cox proportional hazards model.

  • CCI, Charlson Comorbidity Index; DCSI, Diabetes Complications Severity Index; DM, diabetes mellitus; P4P, pay for performance.