Australian National Diabetes Information Audit & Benchmarking (ANDIAB) 2011 Final Report

3. Discussion

A discussion of the results and outcomes of ANDIAB 2011

Page last updated: December 2011

The original aim of the Australian National Diabetes Information Audit & Benchmarking [ANDIAB] initiative was to establish a quality audit program. This was to be achieved by the collection, collation, analysis, audit and reporting of clinical diabetes data in specialist diabetes services, and in so doing, the underlying objectives included, and have remained :

  • To develop a quality data program;
  • To provide an individual audit report for participants;
  • To utilise different technologies to collect and collate data;
  • To assess participant responses;
  • To generate a pooled data collection report of standardised data;
  • To encourage progress towards annual collection; and
  • To constantly update and refine.
ANDIAB 2011 has again shown that clinical diabetes data can be collected and collated in a meaningful way, using standardised data items that are part of a nationally promulgated minimum dataset. The original objectives that are stated above have all been addressed.

The ANDIAB initiative has therefore evolved to encompass dual purposes. Firstly, it is a Quality Assurance – Benchmarking Activity held in Specialist Diabetes Services [Diabetes Centres and Specialist Endocrinologists Rooms] across Australia. Secondly, ANDIAB is a source of cross-sectional national de-identified data describing the clinical status of individuals with diabetes. Commenced as a one-month ‘survey’ audit, with the development of ANDIAB Software, (and the ability to incorporate data extracted from existing databases), sites have been encouraged to collect the data items [as an Annual Review] on a small number of individuals each clinic and hence submit data accumulated over a period of up to the prior 12 months [rather than as many as possible in the one month survey period]. The use of ANDIAB Software has declined over the years, with no-one using it in 2011.

The data are clinically relevant demographic, examination and laboratory findings that describe the clinical status of an individual at a point in time. A review of collated data for trends over time, indicates relative stability of data that we interpret to indicate that this initiative does provide an accurate picture of the status of these individuals. ANDIAB mirrors international initiatives [esp in Europe] and the Dataset was accepted as the first Clinical Dataset in the National Health Data Dictionary [NHDD]. This dataset has since been enhanced, and is now online as part of the AIHW – Metadata Online Registry [‘METeOR’] as the Diabetes (clinical) Data Set Specification at – [see AIHW website]: http://meteor.aihw.gov.au/content/index.phtml/itemId/304865

The Commonwealth has supported this initiative through funding of six of these collections and the 2003 follow-up review, as well as support for a Project Officer to develop the NHDD submission. The National Diabetes Data Working Group [NDDWG] oversees the Dataset, and the National Association of Diabetes Centres [NADC] coordinates the ANDIAB collections. ANDIAB Data have assisted in the provision of data for several diabetes indicators reported by the AIHW.

The Commonwealth funded ANDIAB Project 2011-2012 has provided funds for ANDIAB 2011 [plus an ANDIAB2 collection in 2012] and for the ANDIAB database application to be further reviewed and enhanced. A Data Programmer has been employed to undertake these tasks.

ANDIAB is now a well established Quality program and Data Collection exercise in an environment that still lacks good data systems. Participants obtain important information on their service provision via an external national benchmarking process. The data reflect the current health status of patients and indicate what is happening in practice. Comparison with previous collections can provide information on service delivery trends. Future surveys could be targeted to address specific issues or patient populations.

ANDIAB has used a simple [one-page] data collection instrument to collect a standardised dataset of demographic, clinical, biochemical and outcome data on people with diabetes attending specialist diabetes services across Australia. The 2011 collection has built on and further enhanced the 1998, 1999, 2000, 2002, 2004, 2006 and 2009 collections, with the addition of just two new fields (eGFR and eGFR Result).

The 2011 de-identified cross-sectional data were pooled and analysed, and the results which form the basis of this report, provide a snapshot of the clinical status of these people with diabetes. These data are summarised :

[a] in Tables 6, 7 & 8 {Risk Factor Data; Complications/ Events in the last 12 months and prior to the last 12 months; Current Data}[pp 12-13], and
[b] in the Final Report - Pooled Data (December 2011) [Appendix 7] where they are compared with data from previous years’ surveys.

Participating specialist diabetes services receive individualised feedback in the form of an audit report comparing their patient profile with other participants. This assessed process and outcome findings for all data fields, to enable individual specialists/sites to compare and benchmark their practice findings against other participating individual specialists/sites. This indvidualised feedback also provided up to 6 year data comparison reports to enable sites to compare their 2011 results with data from their participation in previous ANDIAB surveys. A questionnaire seeking feedback regarding this report was forwarded to each participant, and the responses received, (along with those from the post data collection questionnaire), will be used to determine the content and format of future survey reports.

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