Establishment of the SingHealth Diabetes Registry
Received 7 January 2021
Accepted for publication 1 March 2021
Published 16 March 2021 Volume 2021:13 Pages 215—223
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Vera Ehrenstein
Daniel Yan Zheng Lim,1 Sing Yi Chia,1 Hanis Abdul Kadir,1 Nur Nasyitah Mohamed Salim,1 Yong Mong Bee2,3
1Health Services Research Unit, Singapore General Hospital, Singapore, Singapore; 2Department of Endocrinology, Singapore General Hospital, Singapore, Singapore; 3SingHealth Duke-NUS Diabetes Centre, Singapore Health Services, Singapore, Singapore
Correspondence: Yong Mong Bee
SingHealth Duke-NUS Diabetes Centre, 20 College Road, Academia, Singapore, 169856, Singapore
Tel +65 6321 3753
Fax +65 6227 3576
Email [email protected]
Purpose: To describe the inception and structure of the SingHealth Diabetes Registry (SDR) as well as the methodology used to set up the registry. The SDR was established to facilitate systematic and standardized data collection for diabetes mellitus within Singapore Health Services (SingHealth), which is an Academic Medical Center (AMC) and Singapore’s largest group of healthcare institutions. The diabetes casemix and outcome variables within the registry cohort are also provided.
Materials and Methods: The SDR is built from SingHealth’s electronic medical records (EMR) and clinical databases. It covers all individuals aged 18 and above with diabetes mellitus, excluding those with pre-diabetes. Cases are annually ascertained using criteria that include diagnosis codes, prescription records and laboratory test records. Data collection of casemix and outcome variables for the period 2013 to 2019 is complete.
Results: The SDR stands at 208,102 ascertained individuals, distributed across 8 healthcare sites within the AMC. The cohort is broadly reflective of the local gender and ethnic compositions but has a high proportion of older individuals with a mean age of 65.8 ± 13.7 years. Majority (> 99%) have type 2 diabetes mellitus, with multiple other comorbidities (hypertension 84.1%, hyperlipidemia 86.2%, established cardiovascular disease 34.1%). At present, majority of individuals are able to meet key process indicators and 52.7% have a mean HbA1c of < 7% (53 mmol/mol). Areas of potential improvement include increasing eye and foot screening rates, as well as glycemic control for the 19.5% of individuals with mean HbA1c > 8% (64 mmol/mol).
Conclusion: The SDR is a large-scale, comprehensive, and representative diabetes registry that incorporates EMR data across the primary and hospital-based care continuum, in a major AMC in Singapore. The SDR has identified areas of improvement in diabetes processes and outcomes. It will support future quality assessment and improvements in diabetes care.
Keywords: diabetes mellitus, electronic data processing, epidemiology
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