Electronic Thesis and Dissertation Repository


Master of Science


Epidemiology and Biostatistics


Sarma, Sisira


Effective diabetes management provided in primary care has the potential to reduce hospitalizations and mortality. To improve diabetes management, a Diabetes Management Incentive (DMI) was introduced by the Ontario government for family physicians practicing in patient enrolment models. This thesis has three main objectives: 1) review the literature on the association between financial incentives for diabetes care and diabetes-related hospitalizations and mortality; 2) and 3) examine the impact of DMI on: diabetes-related services, diabetes-related hospitalizations, diabetes-related hospitalization costs, and mortality risk in Ontario. A review of the literature on the incentives revealed inconsistent findings. The impact of DMI was assessed using longitudinal administrative data from the ICES, and analyzed using multivariable difference-in-difference linear regression models. The results showed that DMI was associated with an increase in the provision of diabetes-related services, but had no effect on diabetes-related hospitalizations, hospitalization costs, and mortality risk.