Healthc Inform Res.  2015 Jan;21(1):49-55. 10.4258/hir.2015.21.1.49.

Development of a Virtual Diabetes Register using Information Technology in New Zealand

• Jo EC
• Drury PL

• KMID: 2284598
• DOI: http://doi.org/10.4258/hir.2015.21.1.49

Abstract

OBJECTIVES
The purpose of this study was to consider a Virtual Diabetes Registry System (VDR) and to investigate what it is and how it is used in New Zealand. New Zealand has specified diabetes mellitus (DM) as a national health priority. The Ministry of Health requires an accurate method for tracking the number of people with diagnosed with DM in the population.
METHODS
We combined five national databases, all of which included a unique patient identifier: hospital admissions coded for DM, outpatient attendances for DM, DM retinal screening, prescriptions of specific anti-diabetic therapies, laboratory orders for HbA1c, as well as Primary Health Organisation (PHO) enrolments and national mortality. The algorithm was progressively modified to improve sensitivity and specificity, and it was validated against primary care registers. The algorithm was still being used in 2014.
RESULTS
The prevalence of diagnosed diabetes in New Zealand at December 31, 2009 was 189,256 (4.4% of whole population). The VDR is now used to determine the official diagnosed diabetes prevalence in New Zealand; it is also used to determine the denominator of the health targets that the Ministry of Health should achieve for diabetes service indicators in New Zealand.
CONCLUSIONS
This method appears to be superior to any other practicable national survey and to be both accurate and robust. The VDR has become an invaluable tool for monitoring prevalence and the policy making process, and for supporting clinical quality improvement.

Keyword

Diabetes Mellitus; Prevalence; Epidemiology

MeSH Terms

Diabetes Mellitus
Epidemiology
Health Priorities
Humans
Mass Screening
Mortality
New Zealand*
Outpatients
Policy Making
Prescriptions
Prevalence
Primary Health Care
Quality Improvement
Retinaldehyde
Sensitivity and Specificity
Retinaldehyde

Figure

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  Figure 1 Databases for Virtual Diabetes Registry in New Zealand. DM: diabetes mellitus, ACR: albumin creatinine ratio.

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  Figure 2 Health information flow in relation to diabetes mellitus in New Zealand.

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  Figure 3 New Zealand diabetes prevalence rates by 5-year age group (whole population).

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  Figure 4 Diabetes prevalence rates (end-2009) by age and ethnicity

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  Figure 5 Diabetes prevalence rates by detailed Asian ethnicity.

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  Figure 6 Diabetes prevalence rates in relation to deprivation (higher scores are more deprived).

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  Figure 7 Total diabetes mellitus (DM) patients in New Zealand identified using the same Virtual Diabetes Register (VDR) methodology for the period from December 31, 2005 to December 31, 2013.

Reference

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2. Jo E, Wright C, Dawson S, Drury PL, Orr-Walker B. The development and validation of a 'Virtual Diabetes Registry' (VDR) for monitoring diabetes prevalence and the quality of diabetes care in New Zealand. In : Proceedings of the 8th International Diabetes Federation West Pacific Region Congress; 2010 Oct 4-5; Busan, Korea.

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