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Diabetes, Co-morbidities and Health Service Utilization among Miawpukek First Nation June 2008

Diabetes, Co-morbidities and Health Service Utilization among Miawpukek First Nation June 2008. KD Collins ,T O'Keefe, D MacDonald, K Sikdar, M Murphy, A Roberts, M Organ, D Benoit. Study Objective and Setting.

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Diabetes, Co-morbidities and Health Service Utilization among Miawpukek First Nation June 2008

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  1. Diabetes, Co-morbidities and Health Service Utilization among Miawpukek First NationJune 2008 KD Collins ,T O'Keefe, D MacDonald, K Sikdar, M Murphy, A Roberts, M Organ, D Benoit

  2. Study Objective and Setting To examine the prevalence of diabetes, rates of co-morbidities and health service utilization patterns among Miawpukek First Nation living in Newfoundland and Labrador.

  3. Methodology • Ethics approval • Written consent • Chart review • Diabetes Screening • Local health centre • Data linkage • Chart review • National Diabetes Surveillance System (NDSS) • Hospitalization data • Physicians claims data • Analysis • Diabetes prevalence • Comorbidities • Health service utilization

  4. Results • All Miawpukek aged 20+ in NL were invited to participate • 97% response rate • 95% population included Study Sample

  5. Results Sample Demographic Characteristics Fifty-four per cent 54.3% of the sample were male. Majority of the sample (59.2%) were 20 to 39 years of age.

  6. Results Overall prevalence 13%. Highest among 65+ (45.2%). Prevalence for females (17.9%) twice that of males (8.9%) Diabetes Prevalence, 2002/2003

  7. Results Diabetes prevalence among Miawpukek First Nation approx 1.5 times that of the total NL population. Among females rate more than double. *Source: National Diabetes Surveillance System

  8. Results Average number of visits to the local health center was 4.3 per year. Overall, average number of visits per year was 10.1 and similar for males and females. Average number of outpatient visits per year was higher for those age 40 years and older. * All visits includes visits to local health centre and fee-for-service physicians

  9. Results Majority of visits were to a nurse (approx 75%) for both males and females. Physician visits (GP and Specialist) accounted for small proportion of visits (15.3%). Note: Nurse includes RN, nurse practitioner and LPN

  10. Results 97% had at least one comorbidity Most common comorbidities - hypertension (97%) - renal dysfunction (85%) *percentage having two or more visits to the local health center for the specified condition. If an individual had more than two visits related to the condition over the study period, he/she was counted only once.

  11. Results Hospitalizations by diabetes status and sex, 1995/96 – 2002/03 Average hospitalization rate was considerably higher for those with diabetes. *eight year average, expressed per 100,000 population aged 20+

  12. Results Distribution of Hospitalizations by Cause* and Diabetes Status, 1995/96 – 2002/03 *Most responsible diagnosis; acute care separations only Hospitalization due to circulatory system diseases was higher among those with diabetes (14% vs 5%).

  13. Data on visits to the local health center were collected only for those who had confirmed diabetes through screening. Diabetes screening did not exclude pregnant women, thus diabetes cases identified through screening may include individuals with gestational diabetes. Case definition for capturing cormorbidities not validated. Average annual rates may include data before and after an individual was identified as a diabetes case. Unique isolated population, findings may not be generalizable. Given the small population size, not possible to calculate age-standardized prevalence of diabetes. Limitations

  14. Inclusion of the local Director of Health and Social Services and Miawpukek Chief and Council in proposal development. Developing a Memorandum of Understanding (MOU). Utilizing research staff internalto Conne River Health and Social Services. Regular communications between research staff at both sites. Discussion of the study results with Miawpukek prior to release. Facilitators of Success

  15. Summary and Implications • Results support the observation that diabetes is higher in Aboriginal populations, however lower than reported elsewhere. • Findings being used by Miawpukek First Nation to support chronic disease and health information management strategies. • Study can be built upon for continued diabetes surveillance/research, as well as an expansion to other chronic diseases. • Important partnerships were formed that will be maintained and built upon in future research.

  16. For more information, contact:Kayla CollinsManager, Research and EvaluationNewfoundland and Labrador Centre for Health Informationkaylac@nlchi.nl.ca 709-752-6045 www.nlchi.nl.ca

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