It provides good quality health services at lower cost and increased availability. Diabetes has reached an epidemic stage in Saudi Arabia and has a medical and economic impact at a countrywide level. Data are greatly needed to better understand and plan to prevent and manage this medical problem.
Objective: The Saudi National Diabetes Registry (SNDR) is an electronic medical file supported by clinical, investigational, and management data. It functions as a monitoring tool for medical, social, and cultural bases for primary and secondary prevention programs. Economic impact, in the form of direct or indirect cost, is part of the registry& #8. The registry& #8. GIS) produces a variety of maps for diabetes and associated diseases. In addition to availability and distribution of health facilities in the Kingdom, GIS data provide health planners with the necessary information to make informed decisions. The electronic data bank serves as a research tool to help researchers for both prospective and retrospective studies.
Methods: A Web- based interactive GIS system was designed to serve as an electronic medical file for diabetic patients retrieving data from medical files by trained registrars. Data was audited and cleaned before it was archived in the electronic filing system.
It was then used to produce epidemiologic, economic, and geographic reports. A total of 8. 4,9.
Results: The SNDR reporting system for epidemiology data gives better understanding of the disease pattern, types, and gender characteristics. Part of the reporting system is to assess quality of health care using different parameters, such as Hb. A1c, that gives an impression of good diabetes control for each institute.
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Economic reports give accurate cost estimation of different services given to diabetic patients, such as the annual insulin cost per patient for type 1, type 2, and gestational diabetes, which are 1. SR (US $3. 08), 1. SR (US $3. 75), and 1. SR (US $2. 67), respectively.
Of this, 7. 2. 0. The SNDR can provide an accurate assessment of the services provided for research purposes. For example, only 2. Conclusions: The SNDR is an effective electronic medical file that can provide epidemiologic, economic, and geographic reports that can be used for disease management and health care planning. It is a useful tool for research and disease health care quality monitoring. The complete bibliographic information, a link to the original publication on http: //www.
Nowadays, e. Health is considered one of the most rapidly growing technologies worldwide. It aims to provide health services at a lower cost with good quality and availability. Chronic diseases are known for their high rate of morbidity, disability, and mortality, in addition to their high cost; they amounted to 7. United States during the year 2. Therefore, e. Health is expected to reduce the effect of such diseases on health and economy. Diabetes mellitus is the most important and frequent chronic disease, as reported by the International Diabetes Federation (IDF), with more than 3.
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The prevalence of mild to severe diabetic neuropathy ranges from 6. In 2. 00. 4, more than 6. Among both diagnosed and undiagnosed diabetic patients, the prevalence of retinopathy ranges from 1.
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Coronary heart disease prevalence reported among adult diabetic patients was as high as 5. The prevalence of diabetic nephropathy among type 2 diabetic patients ranges from 7. This increase is largely because of a 2. North America and the Caribbean region, but also a 1. Southeast Asia region and an 1.
Western Pacific region . Diabetes is also known to be a leading cause of death largely because of increased risk of coronary artery disease and stroke. According to World Health Organization (WHO) data, more than 7. Diabetes prevalence has been estimated at 2. Kingdom, being the highest in the Northern and Eastern regions, which account for 2. The Western and Central regions were 2.
The lowest prevalence is in the Southern region, which accounts for 1. Diabetes in Saudi Arabia has been found to be responsible for 3. This is associated with deficiency in the data required for proper action to prevent and manage this huge medical problem.
In spite of the good health system and facilities currently available in the Kingdom, health care provided to diabetic patients has fallen short of achieving optimal clinical outcomes. This can be attributed to the large number of patients and the limited time allotted for each patient, in which new technology can contribute for good patient’s monitoring and high level of clinical practice. Thus, using a diabetes registry can give us a better understanding of the disease and its impact on patients and the health system. It also provides a chance for research and better planning for disease management in setting the proper standards for medical care. Eventually, it could provide physicians with feedback on their medical care, guiding them to improve their clinical outcomes . It also serves as the basis for epidemiology data, providing better insight into diabetes complications and associated diseases, and aiming to improve disease management and health care quality.
A survey of 1. 04. US physician organizations showed that diabetes registries are used 4. There are limited numbers of diabetes registries globally, some of which are brief and disease- focused, whereas others are made to serve certain objectives. On the other hand, there is a third group of registries made to serve diabetic patients in hospital settings, or that considers diabetes as a component of chronic diseases.
Joslin’s Web- based Diabetes Registry and Risk Stratification System is a Web- based application using Joslin’s evidence- based Clinical Guidelines to identify and intervene with patients who are most likely to develop costly, debilitating, diabetes- related complications . On the other hand, Penn State Hershey Diabetes and Obesity Institute Registry (PSHDOI) is a custom- built application that assists in tracking clinical outcomes for diabetic patients . The Chronic Disease Electronic Management System (CDEMS) has embedded guidelines for a variety of chronic diseases (diabetes, atrial fibrillation, heart failure, coronary heart disease, hyperlipidemia, depression, asthma, and osteoporosis) . None of the currently available registries has used a diabetes registry in a holistic approach or utilized geographic mapping and economic assessment of the disease countrywide.
It also functions as a surveillance- monitoring tool for clinical and epidemiology practitioners by providing key performance indicators related to this disease in either acute or chronic circumstances. The SNDR will provide data related to the association of diabetes with hypertension, hyperlipidemia, and obesity.
It will also map health care institutions and medical facilities availability and distribution in the Kingdom.
Based on reviews of hospital medical records, highly trained full- time data registrars are assigned to each health institute after an intensive training course on the diabetes registry.
In addition to blood pressure and glycemic markers, fasting blood sugar, random blood sugar, 2- hour post- meal blood sugar, and glycated hemoglobin (Hb. A1c) are also collected. Laboratory measurements include urine analyses for glucose, protein, ketones, liver enzymes assessment, including alkaline phosphate, serum glutamic- pyruvic transaminase (SGPT), serum glutamic oxaloacetic transaminase (SGOT), and total protein; thyroid function test, including thyroid- stimulating hormone (TSH), T4, and T3; and lipids profile, including cholesterol, triglycerides, high- density lipoprotein (HDL), and low- density lipoprotein (LDL).
Lifestyle related to diet and exercise and different therapeutic modalities, namely insulin and oral agents are also included in the registry file. The registry file includes chronic complications, including neuropathy, retinopathy, nephropathy, and vasculopathy, in addition to any associated diseases, such as hypertension, hyperlipidemia, thyroid disease, and others.
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