Diabetes in Ontario - Determination of prevalence and incidence using a validated administrative data algorithm
Diabetes in Ontario - Determination of prevalence and incidence using a validated administrative data algorithm
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DOI：
10.2337/diacare.25.3.512
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发表时间：
2002-03-01
期刊：
影响因子：
16.2
通讯作者：
Bica, A
中科院分区：
文献类型：
--
作者：
Hux, JE;Flintoft, V;Bica, A
目的：关于糖尿病的规模和分布的准确信息可以为政策提供信息并支持卫生保健评估。我们将医生服务索赔（PSCs）和出院摘要（HDAs）联系起来，以确定糖尿病的患病率和发病率。研究设计和方法：使用来自国家HDA数据库的行政数据、安大略省（人口1100万）的psc和人口统计和生命统计登记处的数据，构建了一个回顾性队列。1991-1999年选择所有诊断为糖尿病的HDAs和psc （ICD9-CM250）。先前报道的两种糖尿病识别算法应用如下：“1-claim”（任何HDA或PSC显示糖尿病）和“2-claim”（2年内有1例HDA或2例PSC显示糖尿病）。偶发病例被定义为在至少2年的观察后首次符合糖尿病标准的个体。为了验证，从57名随机选择的医生的初级保健图表中提取的诊断数据（n = 3.317）与行政数据队列相关联，并计算敏感性和特异性。结果：1998年，696,938人符合1项索赔标准，528,280人符合2项索赔标准。糖尿病的敏感性分别为90%和86%；对于1权利要求和2权利要求的算法，特异性分别为92和97%，阳性预测值分别为61和80%。使用双索赔算法，所有年龄患病率从1993年的3.2%上升到1998年的4.5%（成人为6.1%）。发病率保持稳定。结论：行政数据可用于建立基于人群的糖尿病发病率和患病率。安大略的糖尿病患病率正在上升，而且远远高于自我报告的比率。
OBJECTIVE - Accurate information about the magnitude and distribution of diabetes can inform policy and support health care evaluation. We linked physician service claims (PSCs) and hospital discharge abstracts (HDAs) to determine diabetes prevalence and incidence.RESEARCH DESIGN AND METHODS - A retrospective cohort was constructed using administrative data from the national HDA database, PSCs for Ontario (population 11 million), and registries carrying demographics and vital statistics. All HDAs and PSCs bearing a diagnosis of diabetes (ICD9-CM250) were selected for 1991-1999. Two previously reported algorithms for identification of diabetes were applied as follows: "1-claim" (any HDA or PSC showing diabetes) and "2-claim" (one HDA or two PSCs within 2 years showing diabetes). Incident cases were defined as individuals who met the criteria for diabetes for the first time after at least 2 years of observation. For validation, diagnostic data abstracted from primary care charts (n = 3.317) of 57 randomly selected physicians were linked to the administrative data cohort, and sensitivity and specificity were calculated.RESULTS - In 1998, 696,938 individuals met the 1-claim criteria and 528,280 met the 2-claim criteria. Sensitivity for diabetes was 90 and 86%; for the 1- and 2-claim algorithms, specificity was 92 and 97%, respectively, and positive predictive values were 61 and 80%, respectively. Using the 2-claim algorithm, the all-age prevalence increased from 3.2% in 1993 to 4.5% in 1998 (6.1% in adults). Incidence remained stable.CONCLUSIONS - Administrative data can be used to establish population-based incidence and prevalence of diabetes. Diabetes prevalence is increasing in Ontario and is considerably higher than self-reported rates.