Using data from patient interactions in primary care for population level chronic disease surveillance: The Sentinel Practices Data Sourcing (SPDS) project

Abstract

BackgroundPopulation health planning within a health district requires current information on health profiles of the target population. Information obtained during primary care interactions may provide a valuable surveillance system for chronic disease burden. The Sentinel Practices Data Sourcing project aimed to establish a sentinel site surveillance system to obtain a region-specific estimate of the prevalence of chronic diseases and mental health disorders within the Illawarra-Shoalhaven region of New South Wales, Australia.MethodsIn September 2013, de-identified information for all patient interactions within the preceding 24 months was extracted and collated using a computerised chronic disease management program that has been designed for desktop application (Pen Computer Systems Clinical Audit Tool: ™ (PCS CAT)). Collated patient data included information on all diagnosed pathologies and mental health indicators, clinical variables such as anthropometric measures, and patient demographic variables such as age, sex, geographical location of residence and indigenous status. Age-standardised prevalence of selected health conditions was calculated.ResultsOf the 52 general practices within the 6 major Statistical Local Areas (SLAs) of the health district that met the inclusion criteria, 17 consented to participate in the study, yielding data on n = 152,767 patients, and representing 39.7% of the regional population. Higher than national average estimates were found for the age-adjusted prevalence of chronic diseases such as obesity/overweight (65.9% vs 63.4%), hypertension (11.9% vs 10.4%) and anxiety disorders (5.0% vs 3.8%), but a lower than national average age-adjusted prevalence of asthma (8.0% vs 10.2%) was also identified.ConclusionsThis proof-of-concept study has demonstrated that the scope of data collected during patient visits to their general practitioners (GPs), facilitated through the Medicare-funded primary health care system in Australia, provides an opportunity for monitoring of chronic disease prevalence and its associated risk factors at the local level. Selection of sentinel sites that are representative of the population being served will facilitate an accurate and region-specific system for the purpose of population health planning at the primary care level.

Depressed, anxious and breathless missing out: Weight screening in general practice in a regional catchment of N ew S outh W ales

“…While the results are only specific to the Illawarra Shoalhaven region and cannot be claimed to be generalisable to all of regional Australia, the findings are quite significant from a policy and planning perspective. Unlike other regions, the geographical catchment boundary of the Illawarra Shoalhaven Local Health District were the same as that covered by a single Medicare Local namely the Illawarra‐Shoalhaven Medicare Local at the time of the SPDS data collection 2. This placed the region in a unique and advantageous position in terms of planning and implementing collaborative preventive health initiatives and chronic disease‐monitoring programs across both primary and tertiary sectors of health services delivery.…”

“…The Sentinel Practices Data Sourcing (SPDS) project2 database contains health administrative data obtained through extraction of de‐identified clinical patient information from 17 general practices located in the Illawarra Shoalhaven region of NSW for patient interactions between September 2011 and September 2013. The data set represents 39.7% of the regional population, but due to variable proportional representation of each of the statistical local areas (SLAs) of the Illawarra Shoalhaven, the sample may not be truly representative of the resident population 2.…”

“…The Sentinel Practices Data Sourcing (SPDS) project2 database contains health administrative data obtained through extraction of de‐identified clinical patient information from 17 general practices located in the Illawarra Shoalhaven region of NSW for patient interactions between September 2011 and September 2013. The data set represents 39.7% of the regional population, but due to variable proportional representation of each of the statistical local areas (SLAs) of the Illawarra Shoalhaven, the sample may not be truly representative of the resident population 2. Although it is estimated that 86% of the resident population of the Illawarra Shoalhaven region saw a general practitioner at least once a year in 2011–2012,3 the fact that the sample is only composed of persons who access general practice services, and the unequal representation of constituent SLAs limits its population‐level generalisability.…”

“…The study was performed under the SPDS project2 ethics approval from the Human Research Ethics Committee (Health and Medical) of the University of Wollongong (HE 12/447).…”

“…A recent chronic disease prevalence study conducted in the regional NSW catchment of Illawarra Shoalhaven2 found the region to have a higher prevalence of overweight and obesity compared with the Australian national age standardised figures. With 81–85% of the resident population of regional Australia estimated to see a general practitioner at least once a year (as per 2010–2011 figures),3 general practice has the best opportunity to continually screen their attending patients for overweight and obesity status and monitor their body mass index (BMI), and where applicable their waist circumference for prompt weight management as recommended by the National Health and Medical Research Council 4…”