Planning and Evaluating Outcomes for Wellness Programs: The ADSS Jeffrey A. Johnson School of Public Health University of Alberta.
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Planning and Evaluating Outcomes for Wellness Programs: The ADSS
Jeffrey A. Johnson School of Public Health University of Alberta
Diabetes in Alberta
By the numbers….
Almost
206,000 people
were living with diabetes in Alberta in 2009.
Over
19,000 new cases
were identified in 2009.
Diabetes rates have almost
doubled
over the past decade.
Each year, adults with diabetes see
physicians 2-3 times more
often and spend almost
3 more days in hospital
compared to their non-diabetic counterparts.
People with diabetes have mortality rates
2 times higher
than people without diabetes.
CAHS Report 2010
Diabetes in Alberta
By the numbers….
Alberta ’s Diabetes Surveillance System
Is a partnership between ACHORD/IHE/U of A and Alberta Health and Wellness; tracks the numbers and trends for diabetes in the province over time; is part of a national program run by the Public Health Agency of Canada; provides valuable information on the level of health services used by people living with diabetes.
• •
Goals for the National Diabetes Surveillance System
Enhance capacity for Diabetes surveillance – Provincial / Territorial – Federal Create nationally comparable data: – Epidemiology – – complications / co-morbities health services utilization
Health Care & Data
Canadian Context
Publically Funded, Privately Delivered Age Gender Status Aboriginal Location of Residence Insurance Registry Unique ID
‘PHN’ Demographic Data Mortality
COD
Hospital Unique ID ‘PHN’ DM Status
Incident/Prev Co-Morbidities /Procedures Health Services
ICD-9-CM or ICD-10CA Physician Unique ID ‘PHN’ DM Status
Incident/Prev Co-Morbidities /Procedures Health Services
ICD-9-CM Drug Unique ID DIN Amt Dispensed Prescriber
NDSS Case Definition
2 physician billing claims with a code of ICD-9 250 over 2 years OR 1 hospitalization with a discharge code of ICD-10, codes E10-E14 (ICD-9 prior to 2001/02)
Note: Does not distinguish between T1DM and T2DM
NDSS Report
www.phac-aspc.gc.ca/ccdpc-cpcmc/ndss-snsd
Alberta Diabetes Atlas 2011
1. Background and Methods 2. Epidemiological Trends 3. Children and Adolescents 4. Health Care Utilization 5. Laboratory Testing 6. Cardiovascular Disease ACS, HF, Stroke and Hypertension 7. Foot Disease and LL Amputation 8. Kidney Disease 9. Eye Disease 10. Mental Health Disorders 11. Diabetes in the SA population 12. Gestational Diabetes 13. Key Findings and Policy Options
Number of Albertans Living with Diabetes 1995-2009
Newly Identified Cases of Diabetes 1995-2009
Rate of Diabetes in Alberta, 1995-2009
Alberta Diabetes Prevalence Provincial rate = 5.7%
Age-Specific Diabetes Rates, 2009
Death Rates in Alberta 1995 - 2009
ADSS – Monitoring Diabetes in Alberta
Epidemiologic trends – incidence, prevalence & mortality Diabetes and related comorbidities Health care utilization Standardized reporting – time, age, geography “Customizable” queries for local planning
Diabetes and Heart Disease
Diabetes and Heart Disease (Cases)
Diabetes and Stroke
Diabetes and Hypertension
Diabetes and Depression
Diabetes and Health Care Utilization
Diabetes and Health Care Utilization
Diabetes and Health Care Utilization
Diabetes and Health Care Utilization
Diabetes and Eye Disease Eye Examinations
* Eye examinations by an Ophthalmologist
Diabetes and Laboratory Tests
Diabetes and Laboratory Tests
A1c Diabetes and Laboratory Tests LDL
ADSS ACTIVE DISSEMINATION: Local Information, for Local Planning
Prevalence Rates by Community Age-Adjusted (2006)
Incidence Rates by Community Age-Adjusted (2006)
Diabetes Prevalence Rates for Oyen, (Age-Adjusted) 1995-2006
Diabetes Prevalence Case Counts (2006)
Local Information for Local Planning…
“Diabetes crisis” in Oyen Confirmation with ADSS numbers Case finding phenomenon Retired surgeon GP practice w/ DM focus Presentation to Regional Health Board & Executive Mobilized funding for diabetes outreach team MD, RN, RD, SW travelling DEC 2 monthly visits to Oyen in 2008 Ongoing shared client care model with local PCN Local DM registry Tele-health with Medicine Hat CDM team
www.albertadiabetes.ca
www.albertadiabetes.ca
https://www.interactiveadss.ualberta.ca
You Tube tutorial
ADSS - Enhanced Surveillance & Program Evaluation
P/T Admin data (ADSS) as a foundation Linkages with external datasets Lab data Risk factor surveillance (surveys) Clinical datasets/Patient registries “Social” datasets (e.g., school performance) Cross-walk with other CD surveillance systems (NDSS CCDSS)
Questions...
?
www.achord.ca
www.albertadiabetes.ca