Compliance with process indicators in people with type 2 diabetes and linking incentives in Primary Care

Objective: Pay-for-performance programs to improve the quality of health care are extending gradually, particularly en Primary Health Care. Our aim was to explore the relationship between the degree of compliance with the process indicators (PrI) of type 2 diabetes (T2DM) in Primary Care and linkage to incentives. Design: Cross-sectional, descriptive, observational study. Setting: Six Primary Health Care centers in Seville Aljarafe District randomly selected and stratified by population size. Participants: From 3.647 adults included in Integrated Healthcare Process of T2DM during 2008, 366 patients were included according sample size calculation by stratified random sampling. Measurements: PrI: eye and feet examination, glycated hemoglobin, lipid profile, microalbuminuria and electrocardiogram. Confounding: Age, gender, characteristics town for patients and professional variables. Results: The mean age was 66.36 years (standard deviation [DE]: 11,56); 48.9% were women. PrI with better compliance were feet examination, glycated hemoglobin and lipid profile (59.6%, 44.3% and 44%, respectively). 2.7% of patients had simultaneous compliance of the six PrI and 11.74% of patients three PrI linkage to incentives. Statistical association was observed in the compliance of the PrI incentives linked or not (P=.001). Conclusions: The degree of compliance with the Prl for screening chronic complications of T2DM is mostly low but this was higher on indicators linked to incentives. (C) 2013 Elsevier Espana, S.L.U. All rights reserved.