Part 3: Analysing, reporting, and using information from diabetes services

Effectiveness of the Get Checked diabetes programme.

Regular reporting of programme data to general practitioners

In our Get Checked report, we recommended that programme administrators (or PHOs) regularly analyse and report information from the programme to GPs to enable them to benchmark their performance.

In 2009, most DHBs reported to us that programme administrators (or PHOs) are regularly analysing and reporting data from the programme to GPs. Most DHBs told us that the frequency of reporting to general practices was either monthly or quarterly. In our view, this frequency is appropriate.

Only one DHB told us that its programme administrator was not regularly reporting information from the programme to GPs. We encourage this DHB, and any others where programme administrators or PHOs are not reporting to GPs, to work with programme administrators or PHOs to achieve regular reporting to GPs.

Question to consider:
4. If the GPs in your district are not receiving regular reports on the Get Checked programme, have you identified what needs to be done to achieve regular reporting and are you addressing the problem?

Identifying improvements to the programme

In our Get Checked report, we recommended that the Ministry and DHBs analyse data from the programme to better understand how the programme and other factors contributing to diabetes care are linked, and to identify how diabetes care can be improved further (including how the programme can be improved).

We suggested that cohort analysis3 might be helpful in showing whether the programme was leading to more effective management of diabetes.

Since our Get Checked report, the Health Research Council4 commissioned a national study of a group of people in the programme who have Type 2 diabetes. The study examined changes in the health status and management of the group over two years. The results of the study were published in September 2008. The study concluded that participating in the free annual health check may have contributed to improving the clinical management of the group and reduced disparities. The study acknowledged that removing restrictions on the use of statin in 2002, and introducing diabetes management guidelines in 2003, may also have improved the management standards.

In 2009, some DHBs reported to us that they had analysed the treatment and outcomes of patients taking part in the programme. For example, Waitemata DHB told us that it had compared data about patients who were taking part in the programme with those who were not. It found that those taking part in the programme had better process measures of care (for example, retinal screening rates) but that differences in intermediate outcomes (such as HbA1c levels) were small or non-existent. The DHB noted in its study that it was difficult to determine what caused the differences because these two patient groups may have been different for reasons other than participating in the programme.

No DHB reported to us that they had carried out cohort analysis using the data from the programme.

Question to consider:
5. Have you considered (either individually or with other DHBs or organisations) carrying out further analysis (for example, cohort analysis) using the data from the Get Checked programme to identify improvements that could be made to diabetes care?

Managing service demand

Current demand

In our Get Checked report, we said that DHBs should collect information from their specialist diabetes services about:

  • the number of patients attending the service;
  • the complexity of patients’ conditions; and
  • waiting times.

This would allow DHBs to identify whether there is a need for more services and, if necessary, to take action to provide more services.

In 2009, most DHBs reported that they were working towards collecting this information. For example, Capital and Coast DHB reported that its specialist diabetes team records information about its patients, including the reason for referral and waiting time. This information can be accessed when needed. The DHB’s specialist diabetes team was also working on creating a program that will automatically analyse the information.

Question to consider:
6. Are you collecting enough information to identify any shortages in your specialist diabetes services and taking action to provide more services where they are needed?

Future demand

In our Get Checked report, we said that DHBs should be using information from the programme about the number of people who are likely to suffer certain complications from diabetes. For example, the programme was collecting information on the number of people who may develop diabetic kidney disease. It is important that DHBs collect and use this type of information when planning services to treat patients with certain diabetes complications.

We recognise that some DHBs may be using this information already but did not report it to us in 2009.

Question to consider:
7. Are you using information about the potential incidence of complications from diabetes to inform your service planning?

3: A cohort analysis follows a defined population, in this case defined by the year the people started participating in the programme, to establish whether there is any change in the recorded results over time.

4: The Health Research Council is the Crown agency responsible for managing investment in public good health research. The Minister of Health is responsible for the Health Research Council, with most of its funding coming from Vote Research, Science and Technology.

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