Effects of a pay-for-performance program for schizophrenia at a Psychiatric Hospital in Northern Taiwan

Objectives: This study determined the effects of a "pay-for-performance program for schizophrenia" on patient utilization of the outpatient department, emergency services, and hospitalization. Methods: This study analyzed 2236 patients from a psychiatric hospital in northern Taiwan who joined the "pay-for-performance program for schizophrenia." Two datasets were analyzed, including the 2009-2013 Hospital Information System and the Schizophrenia Case Management System. The Generalized Estimating Equation (GEE) method was used to determine the effects of the program on patient utilization measures. Results: The "pay-for-performance program for schizophrenia" significantly decreased the yearly incidence of compulsory hospitalization, days of acute psychiatric hospitalization, and annual emergency department visits. In addition, the number of psychiatric outpatient visits decreased significantly, but persisted at > 12 times per year. The number of 6-month readmissions to the acute psychiatric ward did not change significantly after implementing the program. Conclusions: Implementing the "pay-for-performance program for schizophrenia" enhanced self-management of schizophrenic patients, improved medical care outcomes, and prevented worsening of diseases.