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Planning and Evaluating Outcomes for Wellness Programs: The ADSS
Jeffrey A. JohnsonSchool of Public Health
University of Alberta
Diabetes in AlbertaDiabetes in AlbertaBy the numbers….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 AlbertaDiabetes in AlbertaBy the numbers….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.
5
04/10/2302/17/2006
5
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
www.phac-aspc.gc.ca/ccdpc-cpcmc/ndss-snsd
Health Care & DataCanadian ContextPublically Funded, Privately Delivered
Prescriber
Amt Dispensed
DIN
Unique ID
Mortality
Demographic Data
Hospital PhysicianInsurance Registry
Age
Gender
Location of Residence
Status Aboriginal
Co-Morbidities/Procedures
DM StatusIncident/Prev
DM StatusIncident/Prev
Co-Morbidities/Procedures
Drug
ICD-9-CMor
ICD-10CA
ICD-9-CMVital StatisticsCOD
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 Case Definition
NDSS Report
www.phac-aspc.gc.ca/ccdpc-cpcmc/ndss-snsd
Alberta Diabetes Atlas 2011Alberta 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 DiabetesNumber of Albertans Living with Diabetes1995-20091995-2009
Newly Identified Cases of DiabetesNewly Identified Cases of Diabetes1995-20091995-2009
Rate of Diabetes in Alberta, 1995-2009Rate of Diabetes in Alberta, 1995-2009
Alberta Diabetes Prevalence Alberta Diabetes Prevalence
Provincial rate = 5.7%
Age-Specific Diabetes Rates, 2009Age-Specific Diabetes Rates, 2009
Death Rates in AlbertaDeath Rates in Alberta1995 - 20091995 - 2009
ADSS – Monitoring ADSS – Monitoring Diabetes in AlbertaDiabetes 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 DiseaseDiabetes and Heart Disease
Diabetes and Heart Disease (Cases)Diabetes and Heart Disease (Cases)
Diabetes and StrokeDiabetes and Stroke
Diabetes and HypertensionDiabetes and Hypertension
Diabetes and DepressionDiabetes and Depression
Diabetes and Health Care UtilizationDiabetes and Health Care Utilization
Diabetes and Health Care UtilizationDiabetes and Health Care Utilization
Diabetes and Health Care UtilizationDiabetes and Health Care Utilization
Diabetes and Health Care UtilizationDiabetes and Health Care Utilization
Diabetes and Eye DiseaseDiabetes and Eye DiseaseEye ExaminationsEye Examinations
* Eye examinations by an Ophthalmologist
Diabetes and Laboratory TestsDiabetes and Laboratory Tests
Diabetes and Laboratory TestsDiabetes and Laboratory Tests
Diabetes and Laboratory TestsDiabetes and Laboratory Tests
A1c
LDL
ADSS Active Dissemination:
Local Information, for Local Planning
Prevalence Rates by CommunityPrevalence Rates by CommunityAge-Adjusted (2006)Age-Adjusted (2006)
Incidence Rates by CommunityIncidence Rates by CommunityAge-Adjusted (2006)Age-Adjusted (2006)
Diabetes Prevalence Rates for Oyen, Diabetes Prevalence Rates for Oyen, (Age-Adjusted) 1995-2006(Age-Adjusted) 1995-2006
Diabetes Prevalence Diabetes Prevalence Case Counts (2006)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.cawww.albertadiabetes.ca
www.albertadiabetes.cawww.albertadiabetes.ca
Inte
ract
ive
Web
site
Inte
ract
ive
Web
site
https://www.interactiveadss.ualberta.cahttps://www.interactiveadss.ualberta.ca
You Tube tutorial
ADSS - Enhanced ADSS - Enhanced Surveillance & Program Surveillance & Program EvaluationEvaluation
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)
