joint strategic needs assessment foundation profile - JSNA

Interative Hull Atlas: www.hullpublichealth.org/Pages/hull_atlas.htm More information: www.jsnaonline.org and www.hullpublichealth.org
Table 280: Relationship between prevalence, hospital admission rate and mortality rate
among deprivation quintiles (from Diabetes Equity Audit 2007/2008)
Deprivation Prevalence PBS Age-gender standardised rates per 100,000 pop
quintile on GP modelled Hospital Mortality rate from diabetes (index)
(IMD 2004) registers prevalence admission Residents GP deaths (Hull)
2006/2007, Oct 2006, rate 2004-2005 2005-2006
% (index)* % (index)* 2005/06 to Primary Primary 2
2006/07
(index)*
cause* cause
ndary
cause
Most dep‟d 4.48 (100) 5.73 (100) 2,137 (100) 11.49 (100) 14.42 (100) 50.9 (100)
2 4.52 (101) 6.28 (110) 1,502 (70) 10.40 (91) 11.33 (79) 46.2 (91)
3 4.72 (105) 6.26 (109) 1,294 (61) 9.34 (86) 13.71 (95) 41.6 (82)
4 4.86 (108) 5.57 (97) 1,036 (48) 6.75 (59) 8.63 (60) 38.9 (76)
Least dep‟d 4.05 (90) 4.92 (86) 1,015 (47) 8.25 (72) 4.74 (33) 32.1 (63)
*Hull and East Riding of Yorkshire combined (from Diabetes Equity Audit).
10.3.11 Progress Towards Targets
The target relating to diabetes within the local World Class Commissioning (WCC)
Strategy was to increase the percentage of patients with diabetes who have an HbA1c
of 7.5 or less (indicator DM20). Information at practice level is given the Diabetes Equity
Audit for HbA1c for 2006/2007 available at www.hullpublichealth.org. However, the
indicators for the Quality and Outcomes Framework (QOF) have changed for 2009/2010
and the DM23 indicator relates to having an HbA1c of 7.0 or less (although there are
indicators for 8.0 or less and for 9.0 or less).
Table 281 gives the percentages with the indicator with HbA1c of 7.0 or less (“overall
outcome”) for Hull practices for 2009/2010 with practices grouped based on the mean
deprivation scores and mean age of their patients (see section 3.3.3.3 on page 47 for
more about the groupings). The table gives the number on the diabetes disease register
and the numerators and denominators for the DM23 outcome which refers to having a
HbA1c of 7.0 or less recorded in the last 15 months. From this information, the number
and percentage of exceptions (see section 12.13 for more information on exceptions)
have been calculated. It can be seen that there is considerable variability in the
percentage of exceptions among the practices (excluding the new practices opened
after October 2009 60 , the percentage of exceptions range from 1.2% to 35.7% of those
on the disease register). See section 12.13 for more information, but this could be
because the patients are frail, have other co-morbidities, are terminally ill or measuring
their HbA1c levels would be inappropriate for some medical reasons, or because the
patient (was not invited or) did not attend to review appointments on three separate
occasions. The practices opened since October 2009 have a higher prevalence of
exceptions as they would have had less opportunity to undertake the reviews within the
60 Practices Y02747, Y02748, Y02786 and Y02896.
Joint Strategic Needs Assessment Foundation Profile – Hull Health Profile: Release 3. March 2011. 585