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Planning and Evaluating Outcomes for Wellness Programs: The ADSS

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.

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Planning and Evaluating Outcomes for Wellness Programs: The ADSS

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

  2. Diabetes in AlbertaBy 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.

  3. CAHS Report 2010

  4. Diabetes in AlbertaBy 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. 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

  6. Unique ID ‘PHN’ Unique ID ‘PHN’ Unique ID ‘PHN’ Health Services Health Services Health Care & DataCanadian Context • Publically Funded, Privately Delivered Insurance Registry Hospital Physician Drug Age Unique ID Demographic Data Gender DIN DM Status Incident/Prev DM Status Incident/Prev Status Aboriginal Amt Dispensed Mortality Co-Morbidities /Procedures Co-Morbidities /Procedures Prescriber Location of Residence Vital Statistics COD ICD-9-CM or ICD-10CA ICD-9-CM

  7. 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

  8. NDSS Report www.phac-aspc.gc.ca/ccdpc-cpcmc/ndss-snsd

  9. 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

  10. Number of Albertans Living with Diabetes1995-2009

  11. Newly Identified Cases of Diabetes1995-2009

  12. Rate of Diabetes in Alberta, 1995-2009

  13. Alberta Diabetes Prevalence Provincial rate = 5.7%

  14. Age-Specific Diabetes Rates, 2009

  15. Death Rates in Alberta1995 - 2009

  16. 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

  17. Diabetes and Heart Disease

  18. Diabetes and Heart Disease (Cases)

  19. Diabetes and Stroke

  20. Diabetes and Hypertension

  21. Diabetes and Depression

  22. Diabetes and Health Care Utilization

  23. Diabetes and Health Care Utilization

  24. Diabetes and Health Care Utilization

  25. Diabetes and Health Care Utilization

  26. Diabetes and Eye DiseaseEye Examinations * Eye examinations by an Ophthalmologist

  27. Diabetes and Laboratory Tests

  28. Diabetes and Laboratory Tests

  29. Diabetes and Laboratory Tests A1c LDL

  30. ADSS Active Dissemination:Local Information, for Local Planning

  31. Prevalence Rates by CommunityAge-Adjusted (2006)

  32. Incidence Rates by CommunityAge-Adjusted (2006)

  33. Diabetes Prevalence Rates for Oyen, (Age-Adjusted) 1995-2006

  34. Diabetes Prevalence Case Counts (2006)

  35. 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

  36. www.albertadiabetes.ca

  37. www.albertadiabetes.ca Interactive Website

  38. https://www.interactiveadss.ualberta.ca You Tube tutorial

  39. 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)

  40. Questions... ? jeff.johnson@ualberta.ca www.achord.ca www.albertadiabetes.ca

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