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Diabetes Health Intelligence
A Summary of Information:
Yorkshire and the Humber SHA
January 2011
The Local Burden –
Some Facts & Figures
237,000 people aged 17+ diagnosed with diabetes in the Yorkshire and the
Humber SHA area (Source: Quality and Outcomes Framework 2009-10)
This equates to 5.5% of the 17+ population (Source: Quality and Outcomes Framework 2009-10)
The diagnosed prevalence rate in PCT's varied from 4.7% in North
Yorkshire and York PCT and Leeds PCT to 6.7% in Bradford and Airedale PCT
(Source: Quality and Outcomes Framework 2009-10)
Modeling suggests that the current diagnosed prevalence is 75% of the
total prevalence, giving a further 81,000 undiagnosed cases across the
region, raising the total estimated prevalence to 317,000 or 7.5% of the
population (APHO Diabetes Prevalence Model based on 2009-10 QOF data)
By 2030 this total prevalence is expected to rise by 162,000 to 479,000 or
9.5% of the population. Approximately half of this rise is due to the aging
population and half due to rises in obesity (APHO Diabetes Prevalence Model)
The Local Burden –
Some Facts & Figures
Amputations of the foot or leg for those aged 17+ with diabetes are
undertaken at an annual rate of 2.6 per 1,000 people diagnosed with
diabetes in Yorkshire and the Humber SHA. The rate for England is 2.5 per
1,000 people diagnosed with diabetes. (Source aggregated Hospital Episode Statistics Database 200708 to 2009-10 [to ensure a sufficient quantity of procedures]& Quality and Outcomes Framework 2007-10)
Emergency admission rates for ketoacidosis and coma for the region are
5.3 per 1,000 people aged 17 + diagnosed with diabetes. This compares
to a rate of 5.1 per 1,000 nationally (based on aggregated Hospital Episodes Statistics data for 2007-08
and 2008-09 and Quality and Outcomes Framework 2007-08 and 2008-09)
Amongst the PCTs in the region, the highest rate is seen in Leeds PCT (7.1
per 1,000) and the lowest rate in Calderdale PCT (4.0 per 1,000) (based on
aggregated Hospital Episodes Statistics data for 2007-08 and 2008-09 and Quality and Outcomes Framework 2007-08 and 2008-09)
The Local Burden –
Today
Primary Care Trust
Diagnosed
Diabetes
Prevalence
BRADFORD & AIREDALE PCT
6.7%
DONCASTER PCT
6.5%
BARNSLEY PCT
6.2%
NORTH LINCOLNSHIRE PCT
NORTH EAST LINCOLNSHIRE
CTP
WAKEFIELD DISTRICT PCT
6.2%
ROTHERHAM PCT
EAST RIDING OF YORKSHIRE
PCT
KIRKLEES PCT
5.8%
SHEFFIELD PCT
5.6%
CALDERDALE
5.4%
HULL TEACHING PCT
5.2%
LEEDS PCT
NORTH YORKSHIRE AND
YORK PCT
4.7%
ENGLAND
5.4%
5.9%
5.8%
5.8%
5.6%
4.7%
Source: Office for National Statistics
Crown copyright material is reproduced with the
permission of the Office of Public Sector
Information (OPSI).
Contains Ordnance Survey data ©
Crown copyright and database right 2010
The Local Burden –
Tomorrow
20%
18%
Total diagnosed and
undiagnosed
diabetes prevalence
estimates for 2010
and 2030 with
associated
uncertainty limits
16%
14%
12%
10%
8%
6%
4%
2%
Wakefield District
Sheffield
Rotherham
North Yorkshire and
York
North Lincolnshire
Leeds
2030
North East Lincolnshire
2010
Kirklees
Hull
East Riding of Yorkshire
Doncaster
Calderdale
Bradford and Airedale
Barnsley
0%
(Source APHO: Diabetes Prevalence
Model)
The Local Burden
- Variation in Outcomes
2009-10 QOF: percentage of diabetes
17+ register with HbA1c of less than
7%
2009-10 QOF: percentage of diabetes
17+ register with HbA1c of less than 9%
Source: Office for National Statistics
Crown copyright material is reproduced with the
permission of the Office of Public Sector
Information (OPSI).
Contains Ordnance Survey data ©
Crown copyright and database right 2010
The Local Burden –
Variation in Outcomes & Costs
All PCTs
Yorkshire & the Humber SHA
Programme budget spending
against HbA1c outcomes for
2008/09 for PCTs in the region.
(Diabetes
Outcomes
Versus
Expenditure toolkit – DOVE)
95% Confidence Box
3
High costs
Good outcomes
Low costs
Good outcomes
2
5J6
5JE
1
5N5
5NW
5N2
5NX
5NV
0
-3
-2
-1
5N3
5N4
5H8
0
TAN
1
2
5NY
5N1
-1
5EF
Low costs
Poor outcomes
-2
-3
High costs
Poor outcomes
3
Values have been standardised,
resulting in PCTs which are outside
the 95% confidence box having
statistically significantly different
levels of outcomes and/or
expenditure to the national
average.
The Local Burden –
Variation in Outcomes & Costs
All PCTs
Yorkshire & the Humber SHA
Total spend on prescribing against
HbA1c outcomes for 2008/09 for
PCTs in the region. (Diabetes
Outcomes
Versus
Expenditure
toolkit – DOVE)
95% Confidence Box
3
High costs
Good outcomes
Low costs
Good outcomes
2
5JE
5J6
5N2
1
5NX
5N5
5NW
5NV
0
-3
-2
-1
0
TAN
5N3
5N4
5NY
-1
5H8
1
2
5N1
5EF
Low costs
Poor outcomes
-2
-3
High costs
Poor outcomes
3
Values have been standardised,
resulting in PCTs which are outside
the 95% confidence box having
statistically significantly different
levels
of
outcomes
and/or
expenditure to the national average.
The Local Impact –
Diabetes Attributable Deaths
Excess deaths between 20 and 79
years attributable to diabetes, 2005
Primary Care Trust
Diabetes
Attributable
Deaths %
Bradford and Airedale
Kirklees
Sheffield
Barnsley
13.2%
12.3%
12.2%
12.1%
Doncaster
Leeds
Wakefield District
Hull
Calderdale
Rotherham
North East Lincolnshire
North Lincolnshire
East Riding of Yorkshire
North Yorkshire and York
ENGLAND
12.1%
11.9%
11.8%
11.8%
11.8%
11.6%
11.3%
11.2%
10.6%
10.4%
11.6%
Note: Excess deaths are deaths that would not have occurred if
people with diabetes had the same mortality rate as people
without diabetes within a given area
Source: Office for National Statistics
Crown copyright material is reproduced with the
permission of the Office of Public Sector
Information (OPSI).
Contains Ordnance Survey data ©
Crown copyright and database right 2010
References
•
•
•
•
•
Slides 2, 4 & 6: Current prevalence and HbA1c data from the Quality and Outcomes Framework (QOF) for
2009-10, published by The Information Centre for Health and Social Care:
http://www.ic.nhs.uk/qof
Slides 2 & 5:Future prevalence estimates from Association of Public Health Observatories Diabetes
Prevalence Modelling:
http://www.yhpho.org.uk/resource/view.aspx?RID=81090
Slide 3: Data analysis of the Hospital Episodes Statistics Database by Yorkshire and Humber Public Health
Observatory. The amputations data is as yet unpublished and covers all admissions between 2007-08 and
2009-10, the emergency admissions for ketoacidosis, 2007-08 & 2008-09, are published in the Diabetes
Community Health Profiles (which also contain a previous version of amputation rate data)
http://www.yhpho.org.uk/resource/view.aspx?RID=8470
Slides 7 & 8: Information on outcomes and expenditure taken from the Yorkshire and Humber Public
Health Observatory Diabetes Outcomes Versus Expenditure (DOVE) toolkit.
http://www.yhpho.org.uk/default.aspx?RID=8467
Slide 9: Yorkshire and Humber Public Health Observatory Diabetes Attributable Deaths Report, 2005.
http://www.yhpho.org.uk/resource/item.aspx?RID=9909
Key to PCT codes on
variation in outcomes
and costs slides
Primary
Care Trust
Code
5JE
5NY
5J6
5N5
5NW
5NX
5N2
5N1
TAN
5EF
5NV
5H8
5N4
5N3
Primary Care Trust Name
Barnsley
Bradford and Airedale
Calderdale
Doncaster
East Riding of Yorkshire
Hull
Kirklees
Leeds
North East Lincolnshire
North Lincolnshire
North Yorkshire and York
Rotherham
Sheffield
Wakefield District