Table 4 Summary of identified data sources for constructing OECD diabetes indicators

Australia

General Practice Divisions Information Online System 2006-07 [26]

General Practice Divisions network includes about 120 regionally based divisions which facilitate and support active participation by GPs and general practices in primary care activities and programs. General practices' membership with regional divisions is voluntary. All Divisions network members are required to report against a set of National Performance Indicators (including 9 diabetes care related indicators). Diabetes care data are collected annually from practice level diabetes registers.

Indicators 1, 2, 5,6

National General Practice Divisions Diabetes Program, 2002 [35, 36]

The National General Practice Divisions Diabetes Program collected diabetes care data from 16 divisions who used the same electronic diabetes patient register (CARDIAB). GPs provided patient data for entry into divisional registers. Data were extracted from registers only for three years (2000, 2001 and 2002). The project was one-off, with no ongoing data collection arrangement.

Indicators 1-6

Australian National Diabetes Information Audit & Benchmarking 2006 [27]

Diabetes specialist services are delivered primarily through over 60 Diabetes Centres across the nation, and relevant data are collected biennially by the National Association of Diabetes Centres through the Australian National Diabetes Information Audit and Benchmarking (ANDIAB) program. In 2006, 15 Diabetes Centres and 1 specialist endocrinologist in private practice provided de-identified data on a total of 1624 individuals seen during the one-month survey period of October (or November) 2006.

Indicators 1-6

Health Insurance Commission General Practice Statistics, 1999-2000 [1]

Australia has publicly funded, universal health insurance - Medicare. The computerised Medicare billing database records occasions of services provided by general practitioners and specialists. It contains information on service utilisation (e.g. laboratory investigations) for people with diabetes. However, the use of Medicare data to monitor diabetes care at the national level is on an ad hoc basis.

Indicators 1-4

The Australian Diabetes, Obesity, and Lifestyle Study (AusDiab), 1999-2000 [34, 37]

The AusDiab was a population-based study of 11,247 people from randomly selected areas of Australia in 1999-2000. Data collection methods included face-to-face interviews and physical and laboratory measurements. Data related to diabetes care were based on 439 participants who had previously diagnosed type 2 diabetes. The study was a one-off national survey.

Indicators 4-6

Canada

Canadian Community Health Survey 2005 [28]

A national, population-level periodical survey operated on a two-year data collection cycle, which includes diabetes-specific components (optional for inclusion at a province/territory level) in the questionnaire to collect data on diabetes care for those with self-reported diabetes in the general population. The 2005 survey only collected diabetes care related data from six out of thirteen Canadian provinces/territories.

Indicators 1, 4

New Zealand

National Get Checked Programme 2006 [29]

The nationally funded programme provides a free annual check for all people with a diagnosis of type 1 or type 2 diabetes. Services are delivered at the primary level by general practitioners or trained primary care nurses, and a particular effort has been made to ensure maximum access by Maori and Pacific Island peoples. Data are then passed to the Primary Health Organisations, which maintain registers for free annual checks and report aggregated datasets to the Local Diabetes Teams. Local Diabetes Teams combine data and provide annual reports to the District Health Boards and the Ministry of Health on an annual basis.

Indicators 1-6

The US

Medical Expenditure Panel Survey (MEPS), 2004 [30]

The MEPS has two components: the household component and the insurance components. On an annual basis, the household component collects data from a nationally representative sample of families and individuals through household interviews. Information collected includes demographic characteristics, health conditions, health status, use of medical services, charges and source of payments, etc.

Indicators 1, 4

CDC Behavioural Risk Factor Surveillance System (BRFSS) [20]

The BRFSS is a state-based system of health surveys that collects information on health risk behaviours, preventive health practices, and health care access related to chronic disease and injury. Data are collected each year in all 50 states and the District of Columbia, through telephone interviewing of a representative sample of more than 350,000 adults.

Indicators 1, 4

National Health and Nutrition Examination Survey (NHANES), 1999-2004 [30]

The NHANES collects information every few years on a national sample of approximately 40,000 people using face-to-face interviews and physical and laboratory measurements. It asks participants whether they have a history of diabetes and performs blood analyses. The NHANES is valuable in generating national prevalence estimates for diabetes (diagnosed and undiagnosed) as well as in assessing cardiometabolic control among patients.

Indicators 5, 6

Health Plan Employer Data and Information Set (HEDIS), 2006 [31]

The HEDIS is a standardised tool used by the National Committee for Quality Assurance (NCQA) to collect performance data for managed care organisations. HEDIS data cover people enrolled in managed-care plans (commercial insurance, Medicare, and Medicaid). Commercial insurance is usually paid by employers for their employees, Medicaid covers certain individuals and families with low incomes, and Medicare is available for people 65 years or older as well as certain people with disabilities. Managed care organisations are the main source of health care services for persons with diabetes in the US. Data are collected annually by auditing clinical records.

Indicators 1-6

Indian Health Service, Clinical Reporting System, 2006 [32]

The Indian Health Service (IHS) is an agency within the US Department of Health and Human Services, providing health care services to eligible American Indian and Alaska Native people. The IHS reports to Congress each year on the quality of health care provided to its patients as required by the Government Performance and Results Act (GPRA). The GPRA measures comprise a set of clinical and non-clinical indicators, including 6 indicators related to diabetes management. Data for the GPRA diabetes indicators are obtained through the IHS Clinical Reporting System which extracts information from individual patient health records at participating health facilities on an annual basis.

Indicators 1-6

The UK

National Diabetes Audit 2005-2006 [33]

The UK has established the National Clinical Audit Support Programme to assess current diabetes care at primary and secondary care sectors, and to review progress towards achieving the standards set out in the National Service Framework. In 2005-2006, 43% (131/305) of Primary Care Trusts and 52% (102/196) of specialist paediatric units submitted data (with over 750,000 individual patient records) for the National Diabetes Audit. Data are extracted annually from the patient record systems in participating health care organisations.

Indicators 1-6