Use of physician services, risk factor screening and risk factor management, by LHIN event rate group*
| Indicator | LHIN event rate group; % of patients† | p value for trend across LHINs | |||
|---|---|---|---|---|---|
| Low CVD event rate | Medium CVD event rate | High CVD event rate | Overall | ||
| Physician services and risk factor screening | |||||
| Visited a family physician (2006–2007) | 86.4 | 87.5 | 86.4 | 87.0 | 0.2 |
| Annual visits to a family physician (2006–2007), no. per person | 4.2 | 3.6 | 3.5 | 3.8 | 0.01 |
| Periodic health examination (2005–2007) | 63.8 | 56.2 | 48.5 | 57.4 | < 0.001 |
| Visited a specialist (2006–2007) | 60.0 | 57.8 | 55.8 | 58.1 | 0.004 |
| Annual visits to a specialist (2006–2007), no. per person | 1.8 | 1.6 | 1.4 | 1.6 | 0.003 |
| Dyslipidemia screening (2005–2007) | 71.9 | 67.3 | 58.0 | 67.3 | < 0.001 |
| Diabetes screening (2005–2007) | 73.6 | 69.9 | 60.4 | 69.6 | < 0.001 |
| Risk factor management‡ | |||||
| Prescribed statins | 31.4 | 31.9 | 31.3 | 31.7 | 0.4 |
| LDL ≤ 2 mmol/L among statin users | 51.8 | 53.5 | 49.6 | 52.6 | 0.03 |
| Among individuals with hypertension | |||||
| Prescribed ≥ 2 antihypertensive medications | 54.8 | 56.1 | 56.3 | 55.8 | 0.07 |
| Controlled blood pressure§ | 67.4 | 65.0 | 53.3 | 64.4 | 0.04 |
| Annual visits to a family physician for hypertension, no. per person (2008–2012) | 1.1 | 0.9 | 0.8 | 1.0 | 0.005 |
| Among individuals with diabetes | |||||
| Prescribed any antiglycemic medication | 70.9 | 70.1 | 74.1 | 70.8 | 0.03 |
| Prescribed any ACE inhibitor or ARB | 67.2 | 67.7 | 69.4 | 67.7 | 0.1 |
| Prescribed statins | 60.8 | 60.4 | 57.2 | 60.2 | 0.004 |
| HbA1C ≤ 7% | 58.2 | 59.6 | 60.8 | 59.3 | 0.7 |
Note: ACE = angiotensin-converting enzyme, ARB = angiotensin II receptor blocker, CI = confidence interval, CVD = cardiovascular disease, HbA1C = glycated hemoglobin, LDL = low-density lipoprotein, LHIN = Local Health Integration Network.
↵* Values are age- and sex-standardized to the 2006 Ontario census population.
↵† Unless stated otherwise.
↵‡ Prescribed medications are in the 100 days before Jan. 1, 2008 among ≥ 65 year olds on Jan. 1, 2007 (n = 984 101). Antihypertensive medications are among individuals prescribed at least 1 antihypertensive medication (n = 460 090). Medications and HbA1c ≤ 7% among individuals with diabetes are restricted to those with laboratory confirmed diabetes or a history of prescriptions for antiglycemic medications before Jan. 1, 2008 (n = 64 163). LDL ≤ 2 mmol/L and HbA1c ≤ 7% are based on the latest result available between 2008 and 2012. LDL ≤ 2 mmol/L is the target in Canadian Dyslipidemia Guidelines.6
↵§ Defined as < 140/90 mm Hg based on the average of the 3 most recent measurements during 2008–2012 among hypertensive patients in the Electronic Medical Record Administrative data Linked Database (EMRALD).