Table 3. Effects of the pre-end-stage renal disease pay-for-performance program on the 3-year mortality after dialysis.

	Events (Incidence per 1,000 patient year)	Adjusted hazard ratio (95%CI)			PS-matched hazard ratio (95%CI)
		Model 1	Model 2	Model 3	Model 4
All cause
Non-P4P	8485 (171.6)	1.00 [Reference]	1.00 [Reference]	1.00 [Reference]	1.00 [Reference]
P4P	2216 (125.1)	0.71 (0.67–0.74)	0.71 (0.68–0.74)	0.78 (0.75–0.82)	0.77 (0.73–0.82)
Cause of death
Cardiovascular disease
Non-P4P	598 (12.1)	1.00 [Reference]	1.00 [Reference]	1.00 [Reference]	1.00 [Reference]
P4P	117 (10.0)	0.86 (0.73–1.02)	0.85 (0.72–1.00)	0.86 (0.73–1.03)	0.79 (0.64–0.96)
Infectious disease
Non-P4P	2331 (47.1)	1.00 [Reference]	1.00 [Reference]	1.00 [Reference]	1.00 [Reference]
P4P	609 (34.4)	0.74 (0.68–0.81)	0.75 (0.69–0.82)	0.85 (0.77–0.93)	0.81 (0.72–0.90)
Cancer
Non-P4P	372 (7.5)	1.00 [Reference]	1.00 [Reference]	1.00 [Reference]	1.00 [Reference]
P4P	110 (6.2)	0.88 (0.71–1.09)	0.88 (0.71–1.10)	0.90 (0.72–1.13)	0.86 (0.67–1.11)
Out-off-hospital cardiac arrest
Non-P4P	770 (15.6)	1.00 [Reference]	1.00 [Reference]	1.00 [Reference]	1.00 [Reference]
P4P	178 (10.0)	0.66 (0.56–0.78)	0.66 (0.56–0.78)	0.68 (0.57–0.80)	0.65 (0.54–0.79)

Abbreviation: P4P, pay for performance; CI, confidence interval; PS, propensity score.

Subdistribution hazard model was used to estimate cause-specific mortality after consideration of competing risk of other causes.

Model 1: adjusted patient characteristic (age, sex, socioeconomic status, urbanization, and modality).

Model 2: adjusted factors listed in model 1+major coexisting disease (hypertension, diabetes, cardiac disorder, ischemic stroke, gout, and peripheral vascular diseases), and Charlson score.

Model 3: adjusted factors listed in model 2+ confounding drugs (diabetic drugs, anti-hypertensive drugs, analgesic drugs, anti-lipid drugs, erythropoietins).

Model 4: analysis only in patients with propensity score matching.