Planning and Evaluating Outcomes for Wellness Programs: The ADSS Jeffrey A. Johnson School of Public Health University of Alberta.

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Transcript Planning and Evaluating Outcomes for Wellness Programs: The ADSS Jeffrey A. Johnson School of Public Health University of Alberta.

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

Vital Statistics

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...

?

[email protected]

www.achord.ca

www.albertadiabetes.ca