Lim Daniel Yan Zheng, Chia Sing Yi, Abdul Kadir Hanis, Mohamed Salim Nur Nasyitah, Bee Yong Mong
Health Services Research Unit, Singapore General Hospital, Singapore, Singapore.
Department of Endocrinology, Singapore General Hospital, Singapore, Singapore.
Clin Epidemiol. 2021 Mar 16;13:215-223. doi: 10.2147/CLEP.S300663. eCollection 2021.
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.
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.
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).
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.
描述新加坡健康城糖尿病登记处（SDR）的创建过程、结构以及建立该登记处所采用的方法。SDR的设立旨在促进新加坡健康服务机构（SingHealth）系统、规范地收集糖尿病数据，SingHealth是一家学术医疗中心（AMC），也是新加坡最大的医疗保健机构集团。同时还提供了登记队列中的糖尿病病例组合和结局变量。
SDR基于SingHealth的电子病历（EMR）和临床数据库构建。它涵盖所有18岁及以上的糖尿病患者，不包括糖尿病前期患者。每年使用包括诊断代码、处方记录和实验室检查记录在内的标准来确定病例。2013年至2019年期间病例组合和结局变量的数据收集工作已完成。
SDR确定了208,102名个体，分布在AMC的八个医疗站点。该队列在很大程度上反映了当地的性别和种族构成，但老年个体比例较高，平均年龄为65.8±13.7岁。大多数（>99%）患有2型糖尿病，还有多种其他合并症（高血压84.1%，高脂血症86.2%，已确诊心血管疾病34.1%）。目前，大多数个体能够达到关键流程指标，52.7%的个体平均糖化血红蛋白（HbA1c）<7%（53 mmol/mol）。潜在的改进领域包括提高眼部和足部筛查率，以及改善平均HbA1c>8%（64 mmol/mol）的19.5%个体的血糖控制。
SDR是一个大规模、综合性且具有代表性的糖尿病登记处，整合了新加坡一家主要AMC中基层医疗和医院医疗连续过程中的EMR数据。SDR已确定了糖尿病诊疗过程和结局中需要改进的领域。它将支持未来糖尿病护理的质量评估和改进。
