jeffrey a. johnson, phd stephanie u. vermeulen, msc. university of alberta &
DESCRIPTION
Jeffrey A. Johnson, PhD Stephanie U. Vermeulen, MSc. University of Alberta & Institute of Health Economics August 30, 2007. Key Messages…. Alberta Diabetes Atlas 2007 provides trends over time, across age and regional variation for DM & related conditions. - PowerPoint PPT PresentationTRANSCRIPT
Jeffrey A. Johnson, PhDStephanie U. Vermeulen, MSc.
University of Alberta & Institute of Health Economics
August 30, 2007
Alberta Diabetes Atlas 2007 provides trends over time, across age and regional variation for DM & related conditions.
The prevalence & incidence of DM are increasing in Alberta, and especially among older adults.
People with DM have significantly higher rates of CV disease, eye disease, kidney disease, mental health disorders and overall health care use than people without diabetes.
ADSS can be used locally to accurately assess what the burden of DM and it’s comorbidities are across Alberta.
Creation of an ADSS interactive web site will allow individuals to access rates of DM by region/community in real time.
Key Messages…
ADSS – A Public Health Service…ADSS – A Public Health Service…
“Public health surveillance is the ongoing, systematic collection, analysis, and interpretation of health data essential to the planning, implementation, and evaluation of public health practice, closely integrated with the timely dissemination of these data to those who need to know. . . . A surveillance system includes a functional capacity for data collection, analysis and dissemination…”
-CDC Surveillance Update, 1988
National Diabetes Surveillance SystemNational Diabetes Surveillance System
ADSSADSS
AHW & IHE/ACHORD partnership Deliverables
ADSS Newsletter Regular updates and issue-specific focus
Alberta Diabetes Atlas 2007, 2009, 2011
ADSS Website Timely, region-specific information
ADSS Organization StructureADSS Organization Structure
ADSS Steering Committee
ACHORD/IHEJeff Johnson
Stephanie VermeulenGreg HugelSheri Pohar
Sherry Lydynuik
ADSS StaffACHORD/IHE
Epi WG HC Utilization
WGFirst
Nations WG
Eye Disease
Kidney Disease WG
Mental Health WG
CVD WG
AHW
Alberta Diabetes Atlas 2007Alberta Diabetes Atlas 2007
Acknowledgments
1. Background & Methods
2. Epidemiologic Trends, 1995-2005
3. DM & Health Care Utilization
4. DM & Cardiovascular Disease
5. DM & Lower Limb Amputations
6. DM & Kidney Disease
7. DM & Eye Disease
8. DM & Mental Health
9. DM & First Nations People
10. Key Findings & Policy Options
Glossary
Diabetes PrevalenceDiabetes Prevalence(Age-Adjusted Rates)(Age-Adjusted Rates)
After standardizing for age, prevalence increased from 3.8% in 1995 to 5.3% in 2005 in ages 20 years and over
Diabetes Prevalence*Diabetes Prevalence*(Case Counts)(Case Counts)
* Adult Population
Chinook: Diabetes Prevalence*Chinook: Diabetes Prevalence*(Case Counts)(Case Counts)
*Adult Population
Diabetes PrevalenceDiabetes PrevalenceAge-Specific Rates, 2005Age-Specific Rates, 2005
Diabetes Prevalence* Diabetes Prevalence* Age-Adjusted Rates, 2005Age-Adjusted Rates, 2005
Average Provincial rate = 5.3%
Chinook rate = 5.6%
* Adult Population
Diabetes Incidence Diabetes Incidence (Age-Adjusted Rates)(Age-Adjusted Rates)
In 2005, the overall incidence was 5.6 per 1000 adult residents.This was an average of 5.1 for females and 6.2 for males.
Diabetes Incidence*Diabetes Incidence*(Case Counts)(Case Counts)
* Adult Population
Chinook-Diabetes Incidence*Chinook-Diabetes Incidence*(Case Counts)(Case Counts)
* Adult Population
Diabetes Incidence*Diabetes Incidence*Age-Adjusted Rates, 2005Age-Adjusted Rates, 2005
Average Provincial Rate = 5.6 per 1000
Chinook Rate = 6.0 per 1000
* Adult Population
Diabetes & Mortality*Diabetes & Mortality*(Age-Adjusted Rates)(Age-Adjusted Rates)
* Adult Population
Diabetes Health Care UtilizationDiabetes Health Care UtilizationPhysician Visits, 1995-2005Physician Visits, 1995-2005
GeneralPractitioners
Specialists*
Diabetes Health Care UtilizationDiabetes Health Care UtilizationPhysician Visits, 2005Physician Visits, 2005
Specialists*
GeneralPractitioners
Chinook Diabetes Average = 10.0
Chinook Diabetes Average = 2.8
Diabetes Health Care UtilizationDiabetes Health Care UtilizationEmergency Department Visits, 2005Emergency Department Visits, 2005
Chinook Diabetes Average = 1.4
Diabetes & CVDDiabetes & CVDAcute Coronary Syndrome, 1995-2005Acute Coronary Syndrome, 1995-2005
Diabetes & CVDDiabetes & CVDAcute Coronary Syndrome, 1995-2005Acute Coronary Syndrome, 1995-2005
Diabetes & CVDDiabetes & CVD Age-Adjusted Rates of Acute Coronary Syndrome by Region, 2005
Diabetes & Eye DiseaseDiabetes & Eye DiseaseEye Examinations*, 1995-2005Eye Examinations*, 1995-2005
* Eye examinations by an Ophthalmologist
Diabetes & Eye DiseaseDiabetes & Eye DiseaseEye Examinations*, 2005Eye Examinations*, 2005
* Eye examinations by an Ophthalmologist
Crude Rates of Eye Examination*, 1995-2005Crude Rates of Eye Examination*, 1995-2005
* Eye examinations by an Ophthalmologist
Chinook average in 2005: 37%
Palliser average in 2005: 53%
Diabetes & Eye DiseaseDiabetes & Eye DiseaseLaser Photocoagulation, 2005Laser Photocoagulation, 2005
Crude Rates of Retinal Laser Treatment Crude Rates of Retinal Laser Treatment (Photocoagulation), 1995-2005(Photocoagulation), 1995-2005
Chinook average in 2005: 101/10,000
Palliser average in 2005: 375/10,000
Diabetes and First NationsDiabetes and First Nations
First Nations People living in Chinook have much higher rates of diabetes and have the highest age-specific rates of
diabetes.
Diabetes and the Under 20 Diabetes and the Under 20 PopulationPopulation
Under 20: Under 20: Crude Diabetes Prevalence Rates by Region, 2005Crude Diabetes Prevalence Rates by Region, 2005
Average Provincial Rate = 0.23
Chinook Rate = 0.29
Alberta Diabetes Atlas 2007Alberta Diabetes Atlas 2007
Other topics included:
DM & Lower Limb Amputation
DM & Kidney Disease- Incidence & prevalence of ESRD- Kidney transplants
DM & Mental Health- Affective disorders- Anxiety disorders- Psychoses (organic & non-organic)- Substance abuse disorders
Alberta Diabetes Atlas 2007Alberta Diabetes Atlas 2007Key Findings & Policy OptionsKey Findings & Policy Options
Key Findings & Options:
1. Primary prevention to reduce rising prevalence.
2. Secondary prevention to reduce complications.
3. Enhance Quality of Primary Care.
4. Enhance Access to Primary Care.
5. Recognize mental health burden.
6. Enhanced eye care for diabetes.
7. Diabetes in First Nations People.
8. Enhance scope and depth of DM surveillance.
ADSS ADSS - what is missing…?- what is missing…?- what is next…?- what is next…?
Conditions: DM & pregnancy DM & foot disease DM & cancer
New data: Laboratory surveillance Drug Utilization Risk factor surveillance
How YOU can use the ADSS…How YOU can use the ADSS…
ADSS can be used by the Regions to more accurately assess what the burden of DM and it’s comorbidities are.
Diabetes is one of the conditions expected in performance reports for all health regions in Alberta.
ADSS provides important information and specific numbers that can be included in Regional Health Authority business plans/performance reports.
ADSS Dissemination*ADSS Dissemination*
1. Active dissemination to Regions: Local presentations
Regional Administration MOH/PCNs/DECs Public
2. Ongoing Newsletters
3. ADSS Website
*ADSS Dissemination Sub-Committee: J. Johnson, C. Andres, A. Edwards, D. Friesen, R. Lewanczuk
ADSS WebsiteADSS Website
ADSS Administrative Access
Ability to generate more tailored/specific queries
ADSS Administrative Access
Ability to generate more tailored/specific queries
Health Professional / Regional Access
•Interactive health region/community level data•Ability to generate some tailored queries•Links to diabetes resources for health professionals
Health Professional / Regional Access
•Interactive health region/community level data•Ability to generate some tailored queries•Links to diabetes resources for health professionals
Public Access
•Who We Are and ADSS Structure•Goal/objectives of ADSS•Health region/community level data as presented in Atlas•ADSS Newsletters•Links to diabetes information
Public Access
•Who We Are and ADSS Structure•Goal/objectives of ADSS•Health region/community level data as presented in Atlas•ADSS Newsletters•Links to diabetes information
ADSS Website: Search CriteriaADSS Website: Search Criteria
All of Alberta
Regional Health Authority
Sub-Region
Community
Both Sexes
Male
Female
All Ages
20-34 years
35-49 years
50-64 years
65-74 years
75 + years
Rates/Cases from
1995-2005
Prevalent Diabetes Cases for Chinook, 1995-2005
4,145 4,2574,469
4,7475,005
5,282
5,680
6,044
6,363
6,780
7,207
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Year
Nu
mb
er
of
Cases
Female
Male
Total
DM alone or DM & Disease
First Nations Status
ADSS – Health Research Potential …ADSS – Health Research Potential …
Clinical and health policy research questions are often stimulated by health surveillance activities.
Creation of Atlas 2007 lead to a number of important questions which should be addressed through more in-depth investigation:
Are there differences in health care utilization by socioeconomic status throughout Alberta (across and within health regions)?
Have recently established diabetic nephropathy prevention programs lead to reductions in rates of end-stage renal disease in Alberta?
Do regions with higher rates of eye examinations or eye disease procedures have lower rates of blindness?
Is there a better way to define mental illnesses using the administrative databases?
How many Albertans will be living with diabetes in the next 10 years?
DM Incidence
Primary Prevention Intervention
Control No Intervention
ADSS – Health Research Potential …ADSS – Health Research Potential …
Incidence of MI/Stroke
Quality Improvement Intervention
Control No Intervention
… a province-wide health services research laboratory!
DOVE DOVE Diabetes Outreach Van EnhancementStudy
ADSS – Health Research Potential …ADSS – Health Research Potential …
Alberta Diabetes Atlas 2007 provides trends over time, across age and regional variation for DM & related conditions.
The prevalence & incidence of DM are increasing in Alberta, and especially among older adults.
People with DM have significantly higher rates of CV disease, eye disease, kidney disease, mental health disorders and overall health care use than people without diabetes.
ADSS can be used locally to accurately assess what the burden of DM and it’s comorbidities are across Alberta.
Creation of an ADSS interactive web site will allow individuals to access these numbers in real time.
Key Messages…
