Developing a district diabetic register.
OBJECTIVES: To compile a district wide diabetic register of all diabetic patients registered with general practitioners in the catchment area of a single district general hospital and to compare different approaches to identifying patients. DESIGN: Information for a register was obtained from general practitioners' practice registers, the Prescription Pricing Authority, and hospital diabetic clinic records. SETTING: Catchment area of an inner London district general hospital with a large diabetic clinic. SUBJECTS: All patients with a diagnosis of diabetes resident in or attending general practitioners or hospital clinics in the district or its catchment area. MAIN OUTCOME MEASURES: Prevalence of diabetes, population of patients elicited by different approaches, proportion attending the local district general hospital, cost of using prescription returns for identifying diabetic patients. RESULTS: 4674 patients with diabetes were identified from all sources of information, which corresponds to a mean of 22.4 patients per general practitioner and the prevalence of known diabetes of 1.17%. 39.4% of patients identified had Prescription Pricing Authority returns and 42.8% of patients appeared on practices' diabetic registers. Only 56.5% of patients identified attended the district general hospital. For practices where all sources of information were available, practice registers included 60.4% of all patients, and prescription returns and the clinic register identified 64.9% and 40.6% respectively. The cost of using prescription returns to identify patients not detected in other ways was 6.37 pounds per patient. CONCLUSION: The task of developing district diabetic registers may prove, even in one cross sectional attempt, a major task in many inner city health districts.