Developing a district diabetic register

Abstract

Objectives - To compile a district wide diabetic register of all diabetic patients registered with general practitioners in the catchment area of a single district general hospital and to compare different approaches to identifying patients. Design - Information for a register was obtained from general practitioners' practice registers, the Prescription Pricing Authority, and hospital diabetic clinic records. Setting - Catchment area of an inner London district general hospital with a large diabetic clinic. Subjects - All patients with a diagnosis of diabetes resident in or attending general practitioners or hospital clinics in the district or its catchment area. Main outcome measures - Prevalence of diabetes, population of patients elicited by different approaches, proportion attending the local district general hospital, cost of using prescription returns for identifying diabetic patients. Results - 4674 patients with diabetes were identified from all sources of information, which corresponds to a mean of 22·4 patients per general practitioner and the prevalence of known diabetes of 1·17%. 39·4% of patients identified had Prescription Pricing Authority returns and 42·8% of patients appeared on practices' diabetic registers. Only 56·5% of patients identified attended the district general hospital. For practices where all sources of information were available, practice registers included 60·4% of all patients, and prescription returns and the clinic register identified 64·9% and 40·6% respectively. The cost of using prescription returns to identify patients not detected in other ways was £6·37 per patient. Conclusion - The task of developing district diabetic registers may prove, even in one cross sectional attempt, a major task in many inner city health districts.