Back to top
Field Definitions Add to compare
 
INDICATOR NAME
Name
Percentage of patients with diabetes up-to-date with a retinal examination
Alternate Name
Percentage of patients with diabetes up-to-date with a retinal examination
 
INDICATOR DESCRIPTION
Description
Percentage of diabetic patients aged 40 years and older who have had at least one retinal exam with an ophthalmologist or optometrist in the past 24 months
Indicator Status
Active
HQO Reporting tool/product
Personalized/Custom Reports (includes Practice Reports)
Dimension
Effective
Type
Process
 
DEFINITION AND SOURCE INFORMATION
Unit of Measurement
Percentage
Calculation Methods
Numerator/ Denominator * 100
Numerator including inclusion/exclusion

Number of diabetic patients aged 40 years and older who have had at least one retinal exam with an ophthalmologist or optometrist in the past 24 months

Includes:

Ontario residents aged 40 years and older who are identified in the ODD as diabetics in the previous two years

Only includes patients who received a retinal examination in the past two years as defined by the OHIP fee codes:

  • A111, A112. A115: as long as the treating physician specialty is family medicine, general medicine, or ophthalmologist - A233, A234, A235, A236, A238, A239, A240, K065, K066: as long as the specialist is an ophthalmologist
  • C233, C234, C235, C236: as long as the specialist is an ophthalmologist
  • V401, V405, V406, V408, V409, V450, V451: as long as the specialist is an optometrist
  • V402, V407 and diagnosis code (ICD-9) 250 or 362: as long as the specialist is an optometrist
  • A114 and diagnostic code (ICD-9) 250 or 362 as long as the treating physician specialty is family medicine, general medicine, or ophthalmologist
Denominator including inclusion/exclusion

Total number of diabetic patients aged 40 years and older

Excludes:

  • Patients who were not residents in Ontario in each year
  • Patients with a missing or invalid HCN, date of birth or postal code
  • Age on index date in each corresponding year exams: <40 years
  • Patients lost to follow-up
  • Women with gestational diabetes
Adjustment (risk, age/sex standardization)- detailed
NA
Data Source
Discharge Abstract Database (DAD), Ontario Diabetes Database (ODD), Ontario Drug Benefit (ODB), Ontario Health Insurance Plan (OHIP) Claims History Database, Registered Persons Database (RPDB)
Data provided to HQO by
Institute for Clinical Evaluative Sciences (ICES)
 
OTHER RELEVANT INFORMATION
Caveats and Limitations
ODD does not differentiate between Type I and II cases. Only includes retinal eye exams where a fee-for-service claim was submitted. Exams that were paid out-of-pocket by the patient are not included. Some providers (i.e. ophthalmologists in alternate payment plans) may not submit claims. The percent of patients receiving exams may be underestimated in areas where there are a larger proportion of non FFS providers conducting retinal eye exams
Comments Detailed
Further information on the methodology used to generate a diabetes chronic disease cohort from which diabetic patients in this measure are drawn: The algorithm to identify patients with diabetes links different databases at ICES and is based on having two physician claims with a diagnostic code for diabetes (Dx Code 250) or one OHIP fee code for diabetes management, insulin therapy support, diabetic management assessment codes claim (Q040, K029, K030, K045, K046) or one hospitalisation with a diagnostic code of diabetes within 2 years. Gestational diabetes is excluded from this definition based on the following algorithm: Whenever there was a hospital record with a diagnosis of pregnancy care or delivery between 120 days before and 180 days after a gestational admission date, the diabetic record was considered to be for gestational diabetes, and it was excluded. The administrative data case-definition algorithm for diabetes has a sensitivity of 86% and specificity of 97%.5.
Footnotes
5 Hux JE, Ivis F, Flintoft V, Bica A. Diabetes in Ontario: determination of prevalence and incidence using a validated administrative data algorithm. Diabetes Care 2002; 25:512-516
 
TAGS
Sector
Primary Care
Type
Process
Topic
Chronic Disease
Dimension
Effective
Source
Discharge Abstract Database (DAD), Ontario Diabetes Database (ODD), Ontario Drug Benefit (ODB), Ontario Health Insurance Plan (OHIP) Claims History Database, Registered Persons Database (RPDB)
 
PUBLISH
Publish Datetime
12/04/2016 09:58:00