Diabetes-eye-exams - Health Quality Ontario (HQO)

INDICATOR NAME

Name

Diabetes eye exams

Alternate Name

Percentage of people aged 20 and older with diabetes who had a diabetes eye exam

INDICATOR DESCRIPTION

Description

This indicator measure the percentage of Ontarians with diabetes aged 20 and older who had an eye exam within a 2- year period. A higher percentage is better.

Indicator Status

Active

HQO Reporting tool/product

Public reporting

Dimension

Effective

Type

Process

DEFINITION AND SOURCE INFORMATION

Unit of Measurement

Percentage

Calculation Methods

Numerator divided by the denominator times 100

Numerator including inclusion/exclusion

Number of people with diabetes aged 20 and older (for that specific fiscal year) with a record for eye exam within a 2-year period.

Inclusions:

OHIP feecodes = A115 (major eye exam), A233 to A240 (ophthalmology), C233 to C236 (ophthalmology emergency and out-patient department), Optometrist fee codes V401, V402, V404 to V409, V450, V451 Note: use spec=all when extracting OHIP OHIP fee codes = K065, K066 where spec=23 (Ophthalmology) A110, A111, A112, A114, A252, A253 and A254.

Denominator including inclusion/exclusion

Total number of people with diabetes aged 20 and older in ODD database for the specific fiscal year.

Exclusions:

- People who were not resident in Ontario in each year

- Age on index date in each corresponding year exams: <20 years

- Died before end of follow-up period.

Adjustment (risk, age/sex standardization)- detailed

Direct age and sex adjustment using denominator population (diabetes population aged 20 and older) in the most recent year.

Age groups: 20-29, 30-39, 40-49, 50-59, 60-69, 70+

Data Source

Ontario Diabetes Database (ODD), Ontario Health Insurance Plan (OHIP) Claims History Database

Data provided to HQO by

Institute for Clinical Evaluative Sciences (ICES)

Reported Levels of comparability /stratifications (defined)

Age, Income, Region, Rurality, Sex, Time

OTHER RELEVANT INFORMATION

Caveats and Limitations

-ODD doesn’t distinguish type1 and type 2 diabetes -The ODD is re-created yearly using updated OHIP, CIHI/SDS, and RPDB data. -It is not possible to identify the details/type of the screening using the admin database, instead it was attempted to select all possible opportunities for retinal screening. -The indicator does not specify patients with diabetes that have been already diagnosed with retinopathy. -According to guidelines the appropriate eye exam monitoring intervals are established based on severity of disease.

Comments Detailed

For this indicator the most recent year’s denominator (diabetes population) is used as a standard population, as the age and sex distribution of the diabetes population is very different from the 2011 Canadian Census population, which is used as standard for other indicators in the report.

Footnotes

i Booth GL, Polsky JY, Gozdyra G, Cauch-Dudek K, Kiran T, Shah BR, Lipscombe LL, Glazier RH. Regional Measures of Diabetes Burden in Ontario. April 2012. ii J.H. Kempen B.J. O'Colmain M.C. Leske The prevalence of diabetic retinopathy among adults in the United States Arch Ophthalmol122 2004 552 563 iii Buhrmann R, Hodge W, Beardmore J, Baker G et al. Foundations for a Canadian vision health strategy: Towards preventing avoidable blindness and promoting vision health (PDF document) . Toronto; ON: National Coalition for Vision Health; 2007. Accessed September 3, 2011. iv Clinical Practice Guidelines 2013. http://guidelines.diabetes.ca/Browse/Chapter30