Diabetes-complications - Health Quality Ontario (HQO)

INDICATOR NAME

Name

Complications Among People Living with Diabetes

Alternate Name

Rate of serious complications in the last year among people living with diabetes

INDICATOR DESCRIPTION

Description

This indicator measures the rate of serious chronic complications (death; hospitalization for coronary artery disease, cerebrovascular disease, or peripheral vascular disease; dialysis for end-stage kidney disease) and death in the last year among people with diabetes aged 20 and older.

A lower rate is better.

HQO Reporting tool/product

Public reporting

Dimension

Effective

Type

Outcome

DEFINITION AND SOURCE INFORMATION

Unit of Measurement

Rate per 100 patients

Calculation Methods

Numerator divided by the denominator times 100

Numerator (short description i.e. not inclusions/exclusions)

Number of people with diabetes with any of the complications listed below:

1. Death

2. Coronary artery disease hospitalization (e.g. AMI)

3. Cerebral vascular disease (CVD) hospitalization (e.g. Stroke)

4. Peripheral vascular disease (PVD) hospitalization (i.e. Surgeries for peripheral vascular disease including amputations)

5. Incident end stage renal disease (i.e. requiring dialysis)

6. Any complication (calculated as the first occurrence of any of the above)

Denominator (short description i.e. not inclusions/exclusions)

All cases of diabetes that are prevalent on April 1 of each fiscal year

Adjustment (risk, age/sex standardization)- generalized

Risk adjusted

Data Source

Discharge Abstract Database (DAD), Ontario Diabetes Database (ODD), Ontario Health Insurance Plan (OHIP) Claims History Database, Postal Code Conversion File Plus (PCCF+), Registered Persons Database (RPDB)

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

The indicator only measures serious complications of diabetes. Some outcomes may not be directly related to diabetes (such as death). The indicator is not adjusted for comorbidities. ODD doesn’t distinguish between type 1 and type 2 diabetes. Results for fiscal years 2020/21 and 2021/22 should be interpreted with caution as the COVID-19 pandemic may have affected the number of hospital admissions and deaths among people living with diabetes. We noted fewer hospitalizations and more deaths (the numerator) in the 2020/21 and 2021/22 fiscal years, which affected the rates for some types of diabetes complications.