Association between Time of Pay-for-Performance for Patients and Community Health Services Use by Chronic Patients

Background: Pay-for-performance for patients is a cost-effective means of improving health behaviours. This study examined the association between the pay time for performance for patients and CHS use by chronic patients. Methods: A cross-sectional study was undertaken to estimate distribution characteristics of CHS use in 2011 and collect data of socio-demographic characteristics (sex, age, education level, occupation, disposable personal income in 2011, distance between home and community health agency), chronic disease number, and time of pay-for-performance for patients. Participants were 889 rural adults with hypertension or type II diabetes aged 35 and above. Standardized CHS use means chronic patients use CHS at least once per quarter. Results: Patients who received incentives prior to services had 2.724 times greater odds of using standardized CHS than those who received incentives after services (95% CI, 1.986-3.736, P<0.001). For all subgroups (socio-demographic characteristics and chronic disease number), patients who received incentives prior to services were more likely to use standardized CHS than those receiving incentives after services. Conclusions: Pay time for performance for patients was associated with CHS use by chronic patients. Patients receiving incentive prior to services were more likely to use standardized CHS. And pay time should not be ignored when the policy on pay-for-performance for patients is designed.