Diabetes New Zealand 13 November 2005
World Diabetes Day (Monday 14 November): Diabetes New Zealand Calls for Diabetes Balanced Scorecard
Monday 14 November is World Diabetes Day and Diabetes New Zealand is calling for all District Health Boards (DHBs) to
implement a diabetes balanced scorecard. This follows the results of a pilot scorecard survey of five DHBs identifying
gaps in diabetes services in New Zealand.
“The diabetes scorecard, which was developed by PricewaterhouseCoopers and Diabetes New Zealand, will enable DHBs and
other health service providers to monitor progress in detecting and managing diabetes and help us pinpoint the areas of
greatest need over time,” says Murray Dear, President, Diabetes New Zealand.
“The balanced scorecard is an appropriate management tool that has also been shown in other areas of management to work
well and we see no reason, based on the pilot survey, why it cannot be used in health care.”
“Thanks to the pilot survey, we now have a benchmark and a better picture of what and where the gaps are in diabetes
services. We still have a long way to go. The scorecard is a tool that can drive the kind of urgency needed to confront
the diabetes epidemic.”
“While awareness of diabetes has increased in recent years, so has the epidemic of Type 2 diabetes. The scale of the
condition is not yet reflected with the urgency in which we are required to tackle it as a community. Things are still
moving too slowly and until all people with diabetes are aware that they are entitled to a free annual check, by their
general practitioner, we will continue to be unable to clearly monitor diabetes in New Zealand.”
“We must get greater value out of critical detection and management programs like ‘Get Checked’. This programme was
launched in 2001 with 33% of people with diabetes showing up to their general practitioner for a check. In 2004 the
diabetes detection rate was still only 59% of the expected prevalence of diabetes. This is why the monitoring of
diabetes is so critical,” says Murray Dear. “There is an urgent need to establish a national diabetes database using the
information captured from the ‘Get Checked’ programme,” says Mr Dear.
Key Findings from Pilot Diabetes Scorecard Survey:
In 2004, only 59% of people expected to have been diagnosed with diabetes participated in the ‘Get Checked’ programme.
- Retinal Screening
The number of people enrolled in the ‘Get Checked’ programme who have had diabetes retinal screening in the past four
years has only increased from 64% to 66%.
- Diabetes Management
After four years of the ‘Get Checked’ programme, 29% of people with diabetes have very poor blood glucose levels (an
HbA1c of over 8%). “This rate is unchanged from 2001 and people with diabetes need to understand that well controlled
blood glucose levels help prevent complications of diabetes such as amputations, renal failure and heart disease.”
- Service Improvements
The pilot diabetes scorecard survey identified the following priorities for diabetes service improvements:
o More information and advice on diet
o More responsive services and reduced waiting times
o More specialist referrals (to dietitians, podiatrists and consultants)
o Increased prescription subsidies
- Cost of Diabetes
The cost to DHBs of providing specialist diabetes outpatient and referrals services per person ranges from:
o $173-$217 for a first attendance
o $130-138 for subsequent attendance
o $91-$106 for retinal screening
o $30-$86 for podiatry treatment
- Attendance and Waiting Times
At some DHBs, non-attendance rates were as high as 30% for retinal screening, 20% for physician visits and 13% for
podiatry visits. Waiting times for ophthalmologist visits ranged between as much as 90 – 282 days.
The pilot scorecard survey, undertaken earlier this year, looked at diabetes services across Northland, Waitakere,
Auckland, Hutt Valley and Southland DHBs. A copy of the report, Diabetes New Zealand Balanced Scorecard: Review of the
Pilot Scorecard is available on www.diabetes.org.nz.
The International Diabetes Federation has set up a new website for World Diabetes Day: www.world.diabetesday.org.
Diabetes Awareness Week is from 22-28 November.