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1、Table of Contents,Slides,Sources,Breezing AM, Watson DE, Black C. Chronic conditions and co-morbidity among residents of British Columbia. Vancouver: Centre for Health Services and Policy Research; 2005. Johns Hopkins Bloomberg School of Public Health. The Johns Hopkins Adjusted Clinical Groups (ACG
2、) Case-Mix System Reference Manual. Version 7.0. Baltimore: The Johns Hopkins University; 2005.Johns Hopkins Bloomberg School of Public Health. The Johns Hopkins Adjusted Clinical Groups (ACG) Case-Mix System Technical User Guide. Version 7.0. Baltimore: The Johns Hopkins University; 2005.,Backgroun
3、d:,Chronic diseases affect a significant number of Canadians; account for a large proportion of health care service utilization and associated direct and indirect health care costs; are more common with increasing age and lower socioeconomic status; are often associated with modifiable risk factors
4、such as tobacco use, unhealthy diet and lack of physical activity; are subject to delayed onset; and are often considered to be preventable. Centre for Health Services and Policy Research (CHSPR) at the University of British Columbia identified eleven “high-impact and/or high-prevalence” chronic con
5、ditions. Combinationprevalence and impacthas important implications for the planning and allocation of health care resources.,Background (contd):,Used the Expanded Diagnosis Clusters (EDCs) Johns Hopkins ACG Case-Mix System (version 7.0) tool Estimated “treated” prevalence in Ontario for 2006/07 for
6、 5 of the 11 high-impact and/or high-prevalence chronic diseases, including: Degenerative joint disease (osteoarthritis) Ischemic heart disease (IHD) Cardiac arrhythmia Chronic obstructive pulmonary disease (COPD) Cerebrovascular disease Prevalence rates for other chronic conditions (diabetes, asthm
7、a, cancer, congestive heart failure and hypertension) not reported using the ACG System already being measured, or will be measured in the near future, using validated algorithms developed by ICES and Cancer Care Ontario.,Methodology:,Fiscal year 2006/07 Cohort = Ontarians (derived from the Register
8、ed Persons Database RPDB) EDC algorithm applied to Canadian Institute for Health Informations Discharge Abstract Database (CIHI-DAD) and Ontario Health Insurance Plan (OHIP) records over a two-year period (April 1, 2005 to March 31, 2007) Algorithm mapped CIHI-DAD and OHIP to the following EDCs: Deg
9、enerative joint disease: MUS03 Ischemic heart disease (excluding acute myocardial infarction): CAR03 Cardiac arrhythmia: CAR09 Emphysema, chronic bronchitis, COPD: RES04 Cerebrovascular disease: NUR05,Exclusions: Persons less than 20 years of age (less than 35 years of age for calculation of COPD ra
10、tes) Out-of-province residents Records with missing/invalid age, sex, and/or LHIN information Individuals who died or whose date of last contact with the health care system was greater than 5 years Population estimates (as of April 1, 2006) were calculated using the RPDB. Age- and sex-adjusted preva
11、lence rates were standardized using Ontarios 2001 census population. Neighbourhood median household income ranked by quintiles (obtained from Statistics Canada census data) used as estimate of socioeconomic status (SES),Methodology (contd):,Osteoarthritis (degenerative joint disease),Most common for
12、m of arthritis Causes breakdown of cartilage (covers and protects the ends of bones in joints) Commonly affects joints in the hands, feet and spine and large weight-bearing joints (hips and knees) causing pain, swelling, stiffness, reduced range of joint motion, disability in everyday living activit
13、ies and mobility Greater risk for individuals that are older, overweight, have a family history of osteoarthritis and/or previous joint injury No cure; treatments (e.g., medication, exercise, physiotherapy, weight loss) can increase joint mobility and decrease pain and disability. In severe cases, s
14、urgery may be performed to replace the entire joint, especially the hip or knee.,Key Findings: Osteoarthritis,Overall prevalence rates (2006/07) In 2006/07, little variation in prevalence rates among LHINs Twelve out of 14 LHIN prevalence rates were within 10% of the Ontario rate (9.3 per 100 person
15、s). Highest (11.3 per 100 persons) and lowest (7.6 per 100 persons) rates were observed in the Erie St. Clair and Waterloo Wellington LHINs, respectively.,Age- and sex-adjusted prevalence rate of osteoarthritis per 100 Ontarians aged 20 years and older, 2006/07,By Local Health Integration Network (L
16、HIN) in Ontario,Age- and sex-adjusted prevalence rate of osteoarthritis per 100 Ontarians aged 20 years and older, by sub-LHIN planning area, 2006/07 LHIN 1 (Erie St. Clair) vs. Ontario,Key Findings (contd) : Osteoarthritis,Prevalence rates by sex and/or age group (2006/07) Rates for men and women i
17、n Ontario increased with age, leveling off after 74 years of age. For women, those aged 7584 had highest prevalence rates; for men, rates were highest in the 85+ age group. For both men and women, 5064 age group had highest volume (number of cases). Across all age groups, prevalence rates consistently higher in women than in men at the Ontario level and in most of the LHINs. Disparity was greatest in the 5064 age group where the rates for women were 51% higher than those for men.,
