OBJECTIVES: This article examines the prevalence and incidence of diabetes among Canadians aged 18 or older and risk factors associated with developing the condition. DATA SOURCES: The data are from the 1994/95, 1996/97, 1998/99 and 2000/01 National Population Health Survey and the 2000/01 Canadian Community Health Survey, both conducted by Statistics Canada. ANALYTICAL TECHNIQUES: Descriptive statistics on the prevalence and incidence of self-reported diabetes were computed. Multiple logistic regression was used to identify predictors of incident diabetes. Age-adjusted rates were used to compare diabetic and non-diabetic respondents on a variety of health measures. MAIN RESULTS: In 2000/01, 4.5% of Canadians aged 18 or older, an estimated 1.1 million, reported having diabetes. The incidence from 1994/95 to 2000/01 was 4.9 new cases per 1,000 person-years at risk. When the possible confounding effects of a number of factors were taken into account, advancing age, family history, sedentary leisure time and excess weight were associated with developing diabetes.

Adolescent↗

PubMed2002

The detection and management of abdominal aortic aneurysm: a cost-effectiveness analysis.

BACKGROUND: Abdominal aortic aneurysm (AAA) is an important cause of death in Canada, and about 80% of the deaths are due to ruptured aneurysm. METHOD: To determine the most cost-effective way of controlling AAA in terms of early detection and clinical management, a cohort analysis was undertaken beginning at age 50 years, using a multistate life-table model with parameters derived from published articles. The model was used to determine (a) the optimum size for elective surgery and (b) the optimum rate of detection of intact AAA. Cost per quality-adjusted life-year (QALY) was used to measure outcome. RESULTS: The most cost-effective diameter for repair of an intact AAA increases with age between the limits of 55 and 70 mm. The predominant size for repair is 60 mm. The most cost-effective rate at which latent AAA should be detected is 20% per year, corresponding to a screening interval of 5 years. Selective screening by sex or smoking status, or both, does not improve cost-effectiveness. CONCLUSIONS: Primary care patients aged 50 years and over should be offered abdominal ultrasonography every 5 years. Those with AAA should be kept under surveillance and offered elective surgery when the aneurysm reaches 60 mm in diameter.

Aortic Aneurysm, Abdominal↗

PubMed2002

Hip and knee replacement.

OBJECTIVES: This article examines trends in hip and knee replacement surgery between 1981/82 and 1998/99, focussing on procedures involving seniors. It also presents 1998/99 data on readmissions within 30 days. DATA SOURCES: Data on hip and knee replacement are from the Hospital Morbidity Database for 1981/82 through 1998/99. The Person-oriented Information Database is used to examine readmissions in 1998/99. Supplementary data on arthritis are from the 1998/99 National Population Health Survey. ANALYTICAL TECHNIQUES: Hospitalization rates were calculated by dividing the number of hip and knee surgery separations by the population estimates for the relevant age/sex group and multiplying by 100,000. Population estimates for 1998 were used to calculate age-adjusted hospitalization rates. MAIN RESULTS: Between 1981/82 and 1998/99, the numbers and rates of hip and knee replacement increased substantially, while length of stay for both procedures declined. By 1998/99, knee replacements outnumbered those for hip. Both procedures had relatively low in-hospital mortality and post-surgery complication rates.

Aged↗