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about institute for clinical evaluative sciences (ICES) diabetes data

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  • For each data source, information about data collection and analytical methods, limitations, the citation and additional resources can be found on the Data Sources and Methods page.

The Institute for Clinical Evaluative Sciences (ICES) is an independent not-for-profit corporation that receives core funding from the Ontario Ministry of Health and Long-Term Care.

DATA SOURCE

Original Source: Ontario Health Insurance Plan (OHIP) Claims Database, Discharge Abstract Database (DAD), Same Day Surgery (SDS) Database, Ontario Diabetes Database (ODD)
Distributed by: Institute for Clinical Evaluative Sciences (ICES)
Cite as: Ontario Diabetes Database, 1996-2015, Institute for Clinical Evaluative Sciences (ICES) [Data provided by special request, May, 2017].

METHODS

Data Collection Methods

ICES use data from the following databases to identify individuals with physician-diagnosed diabetes mellitus in Ontario:

  • Ontario Health Insurance Plan (OHIP) Claims Database The OHIP database contains approved physician claims data from inpatient, outpatient and long-term care settings for physicians in Ontario. Among other information, each record identifies the physician, the patient, the diagnosis responsible for the claim (which follows the ICD-9 coding scheme), the service provided and the date of service.
  • Discharge Abstract Database (DAD) The DAD summarizes the hospital discharge information of individuals receiving inpatient care in a non-mental health designated bed. Each record contains demographic, clinical and administrative data regarding the hospitalized individual, including the diagnosis most responsible for the hospitalization (which follows the ICD-9 coding scheme before 2002 and the ICD-10 scheme from 2002 onwards), as well as comorbidities and procedures received.
  • Same Day Surgery (SDS) Database The SDS summarizes same day surgery information about individuals. Each record contains the procedures undergone as well as clinical information about the individual. The clinical information follows the ICD coding scheme (ICD-9 before 2002 and ICD-10 from 2002 onwards).
  • Registered Persons Database (RPDB) The RPDB contains demographic information such as age, sex, health insurance eligibility and death information for anyone who has received Ontario health care coverage. It contains postal code information that is linkable to other geographic information such as public health unit.
  • Ontario Diabetes Database (ODD) The ODD was created using hospital discharge abstracts from the Canadian Institute for Health Information (CIHI) (including the SDS), physician service claims from the OHIP database, and information regarding the demographics of persons eligible for health care coverage in Ontario from the RPDB.
  • Canadian Census 2011 This database contains information from the 2011 Canadian Census including population counts.
  • Yearly Ontario intercensal and postcensal population estimates and projections This database contains yearly estimates of the Ontario population, overall and by smaller geographical units such as public health units, as measured on July 1 of each year.

A patient is said to have physician-diagnosed diabetes if he or she meets at least one of the following algorithm criteria:

  • two OHIP diagnosis code 250 claims; or
  • one OHIP feecode Q040, K029 or K030 claim; or
  • one CIHI admission

within two years.

OHIP
ICD-9 ICD Code name
250 Diabetes mellitus, including complications
Feecode Schedule of Benefits Code name
Q040 Diabetes Management Fee
K029 Intensive Insulin Therapy Counseling
K030 Diabetic Management Fee

CIHI (DAD and SDS)
ICD-9 ICD Code name
250 Diabetes

ICD-10 ICD Code name
E10 Type 1 Diabetes mellitus
E11 Type 2 Diabetes mellitus
E13 Other specified diabetes mellitus
E14 Unspecified diabetes mellitus

Data Analysis Methods

  • Inclusion criteria: All individuals living in Ontario with diabetes. Individuals had to be 20 years and older but less than 106 years.
  • Exclusion criteria: Individuals were excluded if they did not have an Ontario postal code or did not have contact with the Ontario health care system within the past seven years.
  • Prevalence: The numerator was all individuals residing in the Region of Peel or Ontario, diagnosed with diabetes since 1991. The denominator was all individuals living in the Region of Peel or Ontario (according to Ontario population estimates and projections). Total rates were age-sex-standardized and rates by sex were age-standardized to the 2011 Canadian Census population. Age-specific crude rates were also provided.
  • Incidence: For each year (January 1 to December 31) from 1996 to 2014, the numerator was all individuals residing in the Region of Peel or Ontario who were newly identified in that year with diabetes. The denominator was all individuals living in the Region of Peel or Ontario (according to Ontario population estimates and projections) that did not have diabetes (i.e., the susceptible population). Total rates were age-sex-standardized and rates by sex were age-standardized to the 2011 Canadian Census population. Age-specific crude rates were also provided.
  • Cells of less than or equal to 5 individuals are not reportable for privacy reasons, and appear in the tables as "NR" for "Not releasable due to small numbers".

LIMITATIONS

  • The criteria may not distinguish between diabetes types in any of the reported rates due to limitations of OHIP and DAD data in identifying type 1 and type 2 diabetes.
  • The ODD contains information about diabetes cases diagnosed by a physician; however, some people may have diabetes that has not yet been diagnosed.
  • Currently, this data source only provides information at the Census Division (CD) or Public Health Unit (PHU) level of geography.

REFERENCES/RESOURCES

Last updated: February 12, 2019



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