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The future of population registers: linking routine health datasets to assess a population's current glycaemic status for quality improvement
  1. Wing Cheuk Chan1,
  2. Gary Jackson2,
  3. Craig Shawe Wright3,
  4. Brandon Orr-Walker4,
  5. Paul L Drury5,
  6. D Ross Boswell6,
  7. Mildred Ai Wei Lee1,
  8. Dean Papa1,
  9. Rod Jackson7
  1. 1Population Health Team, Strategic Development, Counties Manukau District Health Board, Auckland, New Zealand
  2. 2Health Partners Consulting Group, Auckland, New Zealand
  3. 3Sapere Research Group, Wellington, New Zealand
  4. 4Endocrinology and Diabetes Service, Counties Manukau District Health Board, Auckland, New Zealand
  5. 5Auckland Diabetes Centre, Auckland District Health Board, Greenlane Clinical Centre, Auckland, New Zealand
  6. 6Laboratory Services, Counties Manukau District Health Board, Auckland, New Zealand
  7. 7Section of Epidemiology & Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
  1. Correspondence to Dr W C Chan; wingcheuk.chan{at}cmdhb.org.nz

Abstract

Objectives To determine the diabetes screening levels and known glycaemic status of all individuals by age, gender and ethnicity within a defined geographic location in a timely and consistent way to potentially facilitate systematic disease prevention and management.

Design Retrospective observational study.

Setting Auckland region of New Zealand.

Participants 1 475 347 people who had utilised publicly funded health service in New Zealand and domicile in the Auckland region of New Zealand in 2010. The health service utilisation population was individually linked to a comprehensive regional laboratory repository dating back to 2004.

Outcome measures The two outcomes measures were glycaemia-related blood testing coverage (glycated haemoglobin (HbA1c), fasting and random glucose and glucose tolerance tests), and the proportions and number of people with known dysglycaemia in 2010 using modified American Diabetes Association (ADA) and WHO criteria.

Results Within the health service utilisation population, 792 560 people had had at least one glucose or HbA1c blood test in the previous 5.5 years. Overall, 81% of males (n=198 086) and 87% of females (n=128 982) in the recommended age groups for diabetes screening had a blood test to assess their glycaemic status. The estimated age-standardised prevalence of dysglycaemia was highest in people of Pacific Island ethnicity at 11.4% (95% CI 11.2% to 11.5%) for males and 11.6% (11.4% to 11.8%) for females, followed closely by people of Indian ethnicity at 10.8% (10.6% to 11.1%) and 9.3% (9.1% to 9.6%), respectively. Among the indigenous Maori population, the prevalence was 8.2% (7.9% to 8.4%) and 7% (6.8% to 7.2%), while for ‘Others’ (mainly Europeans) it was 3% (3% to 3.1%) and 2.2% (2.1% to 2.2%), respectively.

Conclusions We have demonstrated that the data linkage between a laboratory repository and national administrative datasets has the potential to provide a systematic and consistent individual level clinical information that is relevant to medical auditing for a large geographically defined population.

  • Epidemiology

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