Background

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(No Transcript)
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Background

• This update is based on Booth GL, Fang J. Acute
  Complications of Diabetes. In Hux JE, Booth GL,
  Slaughter PM, Laupacis A, editors. Diabetes in
  Ontario An ICES Practice Atlas. Toronto
  Institute for Clinical Evaluative Sciences 2003.
  p.19-50.
• Diabetes mellitus (DM) is associated with a
  number of short-term consequences (acute
  complications) that can lead to emergency
  department (ED) visits and hospital admissions,
  many of which are preventable. The frequency of
  these events is therefore indicative of a lack of
  access to effective outpatient care.

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Methodology

• The acute complications measured among Ontarians
  with DM, aged 20 years and older, were
• ED visits for hyper- and hypoglycemia
• Hospital admissions for hyper- and hypoglycemia
• Hospital admissions for common infections and
  skin and soft tissue infections
• Analyses were performed at the provincial, LHIN
  and sub-LHIN planning area level.
• Caution should be taken when comparing the
  results of this update (2002/03 to 2005/06) to
  the Diabetes in Ontario An ICES Practice Atlas
  (1994/95 to 1998/99), due to several refinements
  in the methodology. Additional details are
  available at www.ices.on.ca/intool/.

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Key findings Overall trends 2002/03 to 2005/06

• Increase in ED visit rates for hyperglycemia,
  particularly among those 2034 years of age.
• Slow decline in ED visit rates for hypoglycemia.
• Decrease in hospital admission rates for hyper-
  and hypoglycemia.
• Slight decrease in hospitalization rates for
  common infections.
• Slight decrease in overall hospital admission
  rates for skin and soft tissue infections (but
  with variable trends in age- and sex-specific
  rates).
• Low-income groups consistently had higher rates
  of ED visits and hospitalizations compared to
  high-income groups.

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Key findings Regional variation

• There was significant regional variation (two- to
  threefold) between LHINs in rates of
  hospitalization and ED visits.
• Central West and Central LHINs generally had the
  lowest rates of ED visits and hospitalizations.
• Northern communities generally had higher ED
  visit and hospitalization rates than southern
  communities.
• The greatest rate disparity between LHINs
  occurred in hospitalization rates for skin and
  soft tissue infections where North West LHIN
  rates were three-and-a-half times higher than
  Central LHIN rates.

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Key findings Differences between sex and age
groups

• Young men (2034 years of age) had the highest
  rates of ED visits (hyper- and hypoglycemia) and
  hospitalizations for hyperglycemia.
• Rates of ED visits and hospitalizations for
  hyperglycemia were higher in younger individuals
  (2034 years of age) hospitalization rates for
  hypoglycemia and common infections were highest
  in older individuals (75 years of age and older).
  
• Hospitalization rates for common infections and
  skin and soft tissue infections increased with
  age.

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LHIN Summary Report
Acute Complications of Diabetes 2002/032005/06
Updated November 2007
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Age- and sex-adjusted emergency department (ED)
utilization rates for hyperglycemia per 100,000
Ontarians with diabetes mellitus (DM) aged 20
years and older, 2005/06
By Local Health Integration Network (LHIN) in
Ontario
Utilization rates include visit rate and
patient rate. Visit rate includes multiple visits
for individual patients. Patient rate counts
individuals once regardless of the number of
visits.
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Age- and sex-adjusted emergency department (ED)
utilization rates for hypoglycemia per 100,000
Ontarians with diabetes mellitus (DM) aged 20
years and older, 2005/06
By Local Health Integration Network (LHIN) in
Ontario
Utilization rates include visit rate and
patient rate. Visit rate includes multiple visits
for individual patients. Patient rate counts
individuals once regardless of the number of
visits.
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Age- and sex-adjusted admission rates for
hyperglycemia per 100,000 Ontarians with diabetes
mellitus (DM) aged 20 years and older, 2005/06
By Local Health Integration Network (LHIN) in
Ontario
Admission rates include hospitalization rate
and patient rate. Hospitalization rate includes
multiple admissions for individual patients.
Patient rate counts individuals once
regardless of the number of admissions.
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Age- and sex-adjusted admission rates for
hypoglycemia per 100,000 Ontarians with diabetes
mellitus (DM) aged 20 years and older, 2005/06
By Local Health Integration Network (LHIN) in
Ontario
Admission rates include hospitalization rate
and patient rate. Hospitalization rate includes
multiple admissions for individual patients.
Patient rate counts individuals once
regardless of the number of admissions.
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Age- and sex-adjusted admission rates for
common infections per 100,000 Ontarians with
diabetes mellitus (DM) aged 20 years and older,
2005/06
By Local Health Integration Network (LHIN) in
Ontario
Admission rates include hospitalization rate
and patient rate. Hospitalization rate includes
multiple admissions for individual patients.
Patient rate counts individuals once
regardless of the number of admissions.
Includes urinary tract infections, pneumonia,
bacteremia/septicaemia, and skin and soft tissue
infections
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Age- and sex-adjusted admission rates for skin
and soft tissue infections per 100,000 Ontarians
with diabetes mellitus (DM) aged 20 years and
older, 2005/06
By Local Health Integration Network (LHIN) in
Ontario
Admission rates include hospitalization rate
and patient rate. Hospitalization rate includes
multiple admissions for individual patients.
Patient rate counts individuals once
regardless of the number of admissions.
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Age- and sex-adjusted hospitalization and ED
visit rates for hyperglycemia, hypoglycemia,
common infections and skin soft tissue
infections per 100,000 Ontarians with diabetes
mellitus (DM) aged 20 years and older,
2002/032005/06 LHIN 13 (North East)
Includes urinary tract infections, pneumonia,
bacteremia/septicaemia, and skin and soft tissue
infections
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Age- and sex-adjusted ED visit and
hospitalization rates for hyperglycemia,
hypoglycemia, common infections and skin soft
tissue infections per 100,000 Ontarians with
diabetes mellitus (DM) aged 20 years and older,
2005/06 LHIN 13 (North East) vs Ontario
Includes urinary tract infections, pneumonia,
bacteremia/septicaemia, and skin and soft tissue
infections
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Emergency department (ED) visit rate for
hyperglycemia per 100,000 Ontarians with
diabetes mellitus (DM) aged 20 years and older,
by sex and age group, 2002/032005/06 LHIN 13
(North East) vs Ontario
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Emergency department (ED) visit rate for
hypoglycemia per 100,000 Ontarians with diabetes
mellitus (DM) aged 20 years and older, by sex
and age group, 2002/032005/06 LHIN 13 (North
East) vs Ontario
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Hospitalization rate for hyperglycemia per
100,000 Ontarians with diabetes mellitus (DM)
aged 20 years and older, by sex and age group,
2002/032005/06 LHIN 13 (North East) vs Ontario
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Hospitalization rate for hypoglycemia per 100,000
Ontarians with diabetes mellitus (DM) aged 20
years and older, by sex and age group,
2002/032005/06 LHIN 13 (North East) vs Ontario
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Hospitalization rate for common infections per
100,000 Ontarians with diabetes mellitus (DM)
aged 20 years and older, by sex and age group,
2002/032005/06 LHIN 13 (North East) vs Ontario
Includes urinary tract infections, pneumonia,
bacteremia/septicaemia, and skin and soft tissue
infections
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Hospitalization rate for skin and soft tissue
infections per 100,000 Ontarians with diabetes
mellitus (DM) aged 20 years and older, by sex
and age group, 2002/032005/06 LHIN 13 (North
East) vs Ontario
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Age- and sex-adjusted emergency department (ED)
visit rate for hyperglycemia per 100,000
Ontarians with diabetes mellitus (DM) aged 20
years and older, by neighbourhood income
quintile, 2002/032005/06 LHIN 13 (North East)
vs Ontario
(lowest income)
(highest income)
A measure of overall socioeconomic status
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Age- and sex-adjusted emergency department (ED)
visit rate for hypoglycemia per 100,000
Ontarians with diabetes mellitus (DM) aged 20
years and older, by neighbourhood income
quintile, 2002/032005/06 LHIN 13 (North East)
vs Ontario
(lowest income)
(highest income)
A measure of overall socioeconomic status
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Age- and sex-adjusted hospitalization rate for
hyperglycemia per 100,000 Ontarians with
diabetes mellitus (DM) aged 20 years and older,
by neighbourhood income quintile,
2002/032005/06 LHIN 13 (North East) vs Ontario
(lowest income)
(highest income)
A measure of overall socioeconomic status
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Age- and sex-adjusted hospitalization rate for
hypoglycemia per 100,000 Ontarians with diabetes
mellitus (DM) aged 20 years and older, by
neighbourhood income quintile, 2002/032005/06
LHIN 13 (North East) vs Ontario
(lowest income)
(highest income)
A measure of overall socioeconomic status
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Age- and sex-adjusted hospitalization rate for
common infections per 100,000 Ontarians with
diabetes mellitus (DM) aged 20 years and older,
by neighbourhood income quintile,
2002/032005/06 LHIN 13 (North East) vs Ontario
(lowest income)
(highest income)
Includes urinary tract infections, pneumonia,
bacteremia/septicaemia, and skin and soft tissue
infections
A measure of overall socioeconomic status
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Age- and sex-adjusted hospitalization rate for
skin and soft tissue infections per 100,000
Ontarians with diabetes mellitus (DM) aged 20
years and older, by neighbourhood income
quintile, 2002/032005/06 LHIN 13 (North East)
vs Ontario
(lowest income)
(highest income)
A measure of overall socioeconomic status
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Sub-LHIN Planning Areas Summary Report
Acute Complications of Diabetes 2002/032005/06
Updated November 2007
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Age- and sex-adjusted emergency department (ED)
visit rate for hyperglycemia per 100,000
Ontarians with diabetes mellitus (DM) aged 20
years and older, by sub-LHIN planning area,
2002/032005/06 LHIN 13 (North East) vs Ontario
NR No data in this category or not reportable
due to small cell size.
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Age- and sex-adjusted emergency department (ED)
visit rate for hypoglycemia per 100,000
Ontarians with diabetes mellitus (DM) aged 20
years and older, by sub-LHIN planning area,
2002/032005/06 LHIN 13 (North East) vs Ontario
NR No data in this category or not reportable
due to small cell size.
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Age- and sex-adjusted hospitalization rate for
hyperglycemia per 100,000 Ontarians with
diabetes mellitus (DM) aged 20 years and older,
by sub-LHIN planning area, 2002/032005/06 LHIN
13 (North East) vs Ontario
NR No data in this category or not reportable
due to small cell size.
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Age- and sex-adjusted hospitalization rate for
hypoglycemia per 100,000 Ontarians with diabetes
mellitus (DM) aged 20 years and older, by
sub-LHIN planning area, 2002/032005/06 LHIN 13
(North East) vs Ontario
NR No data in this category or not reportable
due to small cell size.
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Age- and sex-adjusted hospitalization rate for
common infections per 100,000 Ontarians with
diabetes mellitus (DM) aged 20 years and older,
by sub-LHIN planning area, 2002/032005/06 LHIN
13 (North East) vs Ontario
Includes urinary tract infections, pneumonia,
bacteremia/septicaemia, and skin and soft tissue
infections
NR No data in this category or not reportable
due to small cell size.
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Age- and sex-adjusted hospitalization rate for
skin and soft tissue infections per 100,000
Ontarians with diabetes mellitus (DM) aged 20
years and older, by sub-LHIN planning area,
2002/032005/06 LHIN 13 (North East) vs Ontario