scholarly journals Estimating multimorbidity prevalence with the Canadian Chronic Disease Surveillance System

2017 ◽  
Vol 37 (7) ◽  
pp. 215-222 ◽  
Author(s):  
Allison Feely ◽  
Lisa M. Lix ◽  
Kim Reimer
Keyword(s):  
Chronic Disease ◽  
Chronic Diseases ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Chronic Conditions ◽  
Health Agency ◽  
Health Data ◽  
Fiscal Year ◽  
Administrative Health Data ◽  
Disease Surveillance System

Introduction The Public Health Agency of Canada’s Canadian Chronic Disease Surveillance System (CCDSS) uses a validated, standardized methodology to estimate prevalence of individual chronic diseases, such as diabetes. Expansion of the CCDSS for surveillance of multimorbidity, the co-occurrence of two or more chronic diseases, could better inform health promotion and disease prevention. The objective of this study was to assess the feasibility of using the CCDSS to estimate multimorbidity prevalence. Methods We used administrative health data from seven provinces and three territories and five validated chronic conditions (i.e. cardiovascular disease, respiratory disease, mental illness, hypertension and diabetes) to estimate multimorbidity prevalence. We produced age-standardized (using Canada’s 1991 population) and age-specific estimates for two multimorbidity definitions: (1) two or more conditions, and (2) three or more conditions from the five validated conditions, by sex, fiscal year and geography. Results Among Canadians aged 40 years and over in the fiscal year 2011/12, the prevalence of two or more and three or more chronic conditions was 26.5% and 10.2%, respectively, which is comparable to other estimates based on administrative health data. The increase in multimorbidity prevalence with increasing age was similar across provinces. The difference in prevalence for males and females varied by province and territory. We observed substantial variation in estimates over time. Results were consistent for the two definitions of multimorbidity. Conclusion The CCDSS methodology can produce comparative estimates of multimorbidity prevalence across provinces and territories, but there are challenges in using it to estimate temporal trends. Further expansion of the CCDSS in the number and breadth of validated case definitions will improve the accuracy of multimorbidity surveillance for the Canadian population.

scholarly journals The Canadian Chronic Disease Surveillance System: A model for collaborative surveillance

2018 ◽  
Vol 3 (3) ◽  
Author(s):  
Lisa Lix ◽  
James Ayles ◽  
Sharon Bartholomew ◽  
Charmaine Cooke ◽  
Joellyn Ellison ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Health Agency ◽  
Population Based ◽  
Population Characteristics ◽  
Administrative Databases ◽  
Distributed Model ◽  
Case Definitions ◽  
Disease Surveillance System

Chronic diseases have a major impact on populations and healthcare systems worldwide. Administrative health data are an ideal resource for chronic disease surveillance because they are population-based and routinely collected. For multi-jurisdictional surveillance, a distributed model is advantageous because it does not require individual-level data to be shared across jurisdictional boundaries. Our objective is to describe the process, structure, benefits, and challenges of a distributed model for chronic disease surveillance across all Canadian provinces and territories (P/Ts) using linked administrative data. The Public Health Agency of Canada (PHAC) established the Canadian Chronic Disease Surveillance System (CCDSS) in 2009 to facilitate standardized, national estimates of chronic disease prevalence, incidence, and outcomes. The CCDSS primarily relies on linked health insurance registration files, physician billing claims, and hospital discharge abstracts. Standardized case definitions and common analytic protocols are applied to the data for each P/T; aggregate data are shared with PHAC and summarized for reports and open access data initiatives. Advantages of this distributed model include: it uses the rich data resources available in all P/Ts; it supports chronic disease surveillance capacity building in all P/Ts; and changes in surveillance methodology can be easily developed by PHAC and implemented by the P/Ts. However, there are challenges: heterogeneity in administrative databases across jurisdictions and changes in data quality over time threaten the production of standardized disease estimates; a limited set of databases are common to all P/Ts, which hinders potential CCDSS expansion; and there is a need to balance comprehensive reporting with P/T disclosure requirements to protect privacy. The CCDSS distributed model for chronic disease surveillance has been successfully implemented and sustained by PHAC and its P/T partners. Many lessons have been learned about national surveillance involving jurisdictions that are heterogeneous with respect to healthcare databases, expertise and analytical capacity, population characteristics, and priorities.

scholarly journals Quebec Integrated Chronic Disease Surveillance System (QICDSS), an innovative approach

2014 ◽  
Vol 34 (4) ◽  
pp. 226-235 ◽  
Author(s):  
C Blais ◽  
S Jean ◽  
C Sirois ◽  
L Rochette ◽  
C Plante ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Chronic Diseases ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Selection Criterion ◽  
Population Based ◽  
Administrative Databases ◽  
Case Definitions ◽  
Public Health Decision ◽  
Disease Surveillance System

Introduction With the growing burden of chronic diseases, surveillance will play an essential role in improving their prevention and control. The Institut national de santé publique du Québec has developed an innovative chronic disease surveillance system, the Quebec Integrated Chronic Disease Surveillance System (QICDSS). We discuss the primary features, strengths and limitations of this system in this report. Methodology The QICDSS was created by linking five health administrative databases. Updated annually, it currently covers the period from January 1, 1996, to March 31, 2012. The operational model comprises three steps: (1) extraction and linkage of health administrative data according to specific selection criteria; (2) analysis (validation of case definitions essentially) and production of surveillance measures; and (3) data interpretation, submission and dissemination of information. The QICDSS allows the surveillance of the following chronic diseases: diabetes, cardiovascular diseases, respiratory diseases, osteoporosis, osteoarticular diseases, mental disorders, Alzheimer's disease and related disorders. The system also lends itself to the analysis of multimorbidity and polypharmacy. Results For 2011–2012, the QICDSS contained information on 7 995 963 Quebecers with an average age of 40.8 years. Of these, 95.3% met at least one selection criterion allowing the application of case definitions for chronic disease surveillance. The actual proportion varied with age, from 90.1% for those aged 19 years or less to 99.3% for those aged 65 years or over. Conclusion The QICDSS provides a way of producing population-based data on the chronic disease burden, health services and prescription drug uses. The system facilitates the integrated study of several diseases in combination, an approach rarely implemented until now in the context of population surveillance. The QICDSS possesses all the essential features of a surveillance system and supports the dissemination of information to public health decision-makers for future actions.

scholarly journals Chronic Disease Surveillance in Alberta’s Tomorrow Project using Administrative Health Data

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Ming Ye ◽  
Jennifer Vena ◽  
Jeffrey Johnson ◽  
Grace Shen-Tu ◽  
Dean Eurich
Keyword(s):  
Chronic Disease ◽  
Cardiovascular Diseases ◽  
Chronic Diseases ◽  
Prospective Cohort ◽  
Chronic Conditions ◽  
Population Based ◽  
Health Data ◽  
Incidence Rates ◽  
Administrative Health Data

IntroductionAlberta's Tomorrow Project (ATP) is the largest population-based prospective cohort study of cancer and chronic diseases in Alberta, Canada. The ATP cohort data were primarily self-reported by participants on lifestyle behaviors and disease risk factors at the enrollment, which lacks sufficient and accurate data on chronic disease diagnosis for longer-term follow-up. ObjectivesTo characterize the occurrence rate and trend of chronic diseases in the ATP cohort by linking with administrative healthcare data. MethodsA set of validated algorithms using ICD codes were applied to Alberta Health (AH) administrative data (October 2000-March 2018) linked to the ATP cohort to determine the prevalence and incidence of common chronic diseases. ResultsThere were 52,770 ATP participants (51.2± 9.4 years old at enrollment and 63.7% females) linked to the AH data with average follow-up of 10.1± 4.4 years. In the ATP cohort, hypertension (18.5%), depression (18.1%), chronic pain (12.8%), osteoarthritis (10.1%) and cardiovascular diseases (8.7%) were the most prevalent chronic conditions. The incidence rates varied across diseases, with the highest rates for hypertension (22.1 per 1000 person-year), osteoarthritis (16.2 per 1000 person-year) and ischemic heart diseases (13.0 per 1000 person-year). All chronic conditions had increased prevalence over time (p <0.001 for trend tests), while incidence rates were relatively stable. The proportion of participants with two or more of these conditions (multi-morbidity) increased from 3.9% in 2001 to 40.3% in 2017. ConclusionsThis study shows an increasing trend of chronic diseases in the ATP cohort, particularly related to cardiovascular diseases and multi-morbidity. Using administrative health data to monitor chronic diseases for large population-based prospective cohort studies is feasible in Alberta, and our approach could be further applied in a broader research area, including health services research, to enhance research capacity of these population-based studies in Canada.

scholarly journals LO021: Use of health services among non-institutionalized frail elderly with fracture: preliminary results

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S37-S37
Author(s):  
V. Fillion ◽  
S. Jean ◽  
M. Sirois ◽  
P. Gamache
Keyword(s):  
Chronic Disease ◽  
General Practitioner ◽  
Health Services ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Administrative Databases ◽  
Assessment Index ◽  
Preliminary Results ◽  
Disease Surveillance System ◽  
Use Of Health Services

Introduction: Frail older adults experience an increased risk of a number of adverse health outcomes such as comorbidity, disability, dependency, institutionalization, falls, fractures, hospitalization, and mortality. Identification of frail adults is important. The objective of this study is to examine the association between frailty and use of health services (emergency, general practitioner, hospitalization) prior to and following a visit for a fracture in non-institutionalized seniors. Methods: This study is a population-based cohort build from the Quebec Integrated Chronic Disease Surveillance System, an innovative chronic disease surveillance system linking five health care administrative databases. Algorithms using data from this system are accurate and reliable for identifying fractures. The sample includes 179,734 seniors ≥ 65 years old, non-institutionalized in the year before the fracture. Their frailty status was measured using the elderly risk assessment index. Poisson regression models were used to compare use of health services (emergency, general practitioner, hospitalization) 1 year before and 1 year after a visit for a fracture (adjusting for age, sex, comorbidities, social deprivation, material deprivation and site of fracture). Results: Overall, preliminary results show that the use of health services increased significantly in the year following the fracture in frail non-institutionalized elderly vs the non-frail one (p < 0.05). Conclusion: This study suggests that frail seniors with a fracture require more health services after their incident fracture. Furthermore, using a frailty assessment index in health administrative databases can help identify seniors that are at high risk of needing more health services and, therefore, improve their care.

scholarly journals The Canadian Chronic Disease Surveillance System: A Distributed Surveillance Model

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Lisa Lix ◽  
Kim Reimer
Keyword(s):  
Health Insurance ◽  
Chronic Disease ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Feasibility Studies ◽  
Mental Illnesses ◽  
Population Characteristics ◽  
Case Definitions ◽  
Disease Surveillance System ◽  
Disease Case

ObjectiveTo describe the process, benefits, and challenges of implementinga distributed model for chronic disease surveillance across thirteenCanadian jurisdictions.IntroductionThe Public Health Agency of Canada (PHAC) established theCanadian Chronic Disease Surveillance System (CCDSS) in 2009 tofacilitate national estimates of chronic disease prevalence, incidence,and health outcomes. The CCDSS uses population-based linkedhealth administrative databases from all provinces/territories (P/Ts)and a distributed analytic protocol to produce standardized diseaseestimates.MethodsThe CCDSS is founded on deterministic linkage of threeadministrative health databases in each Canadian P/T: health insuranceregistration files, physician billing claims, and hospital dischargeabstracts. Data on all residents who are eligible for provincial orterritorial health insurance (about 97% of the Canadian population) arecaptured in the health insurance registration files. Thus, the CCDSScoverage is near-universal. Disease case definitions are developed byexpert Working Groups after literature reviews are completed andvalidation studies are undertaken. Feasibility studies are initiatedin selected P/Ts to identify challenges when implementing thedisease case definitions. Analytic code developed by PHAC is thendistributed to all P/Ts. Data quality surveys are routinely conductedto identify database characteristics that may bias disease estimatesover time or across P/Ts or affect implementation of the analytic code.The summary data produced in each P/T are approved by ScientificCommittee and Technical Committee members and then submitted toPHAC for further analysis and reporting.ResultsNational surveillance or feasibility studies are currently ongoing fordiabetes, hypertension, selected mental illnesses, chronic respiratorydiseases, heart disease, neurological conditions, musculoskeletalconditions, and stroke. The advantages of the distributed analyticprotocol are (Figure 1): (a) changes in methodology can be easilymade, and (b) technical expertise to implement the methodology is notrequired in each P/T. Challenges in the use of the distributed analyticprotocol are: (a) heterogeneity in healthcare databases across P/Tsand over time, (b) the requirement that each P/T use the minimum setof data elements common to all jurisdictions when producing diseaseestimates, and (c) balancing disclosure guidelines to ensure dataconfidentiality with comprehensive reporting. Additional challenges,which include incomplete data capture for some databases and poormeasurement validity of disease diagnosis codes for some chronicconditions, must be continually addressed to ensure the scientificrigor of the CCDSS methodology.ConclusionsThe CCDSS distributed analytic protocol offers one model fornational chronic disease surveillance that has been successfullyimplemented and sustained by PHAC and its P/T partners. Manylessons have been learned about national chronic disease surveillanceinvolving jurisdictions that are heterogeneous with respect tohealthcare databases, expertise, and population characteristics.

Sign in / Sign up

Export Citation Format

Share Document