Ministry of Health and district health boards: Effectiveness of the "Get Checked" diabetes programme.

Blood glucose
The main sugar that the body makes from the three elements of food – proteins, fats, and carbohydrates (but mostly carbohydrates). Glucose is the major source of energy for living cells and is carried to each cell through the bloodstream.

BMI (Body Mass Index)
A measure of body fat based on height and weight. It is calculated using weight (in kilograms) and height (in metres), and is used to gauge whether a person is underweight, a healthy weight, overweight, or obese.

Clinical audit
The systematic peer evaluation of an aspect of patient care. The process, which may be multidisciplinary, involves a cycle of continuous improvement of care based on explicit and measurable indicators of quality.

Cohort analysis
Follows a defined population, in this case defined by the year the people started participating in the “Get Checked” programme, to establish whether there is any change in their recorded results over time.

Diabetes register
Database of information collected from annual diabetes checks, as set out in Appendix 2.

Diabetes mellitus
A group of metabolic diseases characterised by high blood sugar (glucose) levels, which result from defects in insulin secretion or action, or both. Diabetes mellitus is commonly referred to simply as diabetes.

District health boards
Health management units accountable to the Minister of Health. These have existed since 1 January 2001, when the New Zealand Public Health and Disability Act 2000 came into force.

Glycated haemoglobin (HbA1c) test
Provides an assessment of the degree to which blood glucose has been elevated over 120 days.

A “glycated haemoglobin” molecule made by glucose sticking to the haemoglobin in red blood cells. The more glucose in the blood, the more HbA1c will be present.

Health Funding Authority
Established in January 1998 after the four Regional Health Authorities were disestablished. It allocated government money to health and disability service providers in New Zealand, and was disestablished on 31 December 2000.

The number of instances of a disease or other condition that occur in a population during a specified period of time. It is usually described as a rate, and is calculated by taking the number of new cases in a defined time period as a percentage of a defined population. This allows comparisons to be made over time and between different populations (as long as the rate is standardised to allow for different age structures in different populations).

Independent practitioners association
An association of general practitioners set up in response to the Health and Disability Services Act 1993, as an infrastructure for the provider side of primary health care funding arrangements. The associations are generally established as limited liability companies or trusts, and most are owned by the general practitioner members.

Local diabetes team
A group that includes clinicians and consumers that provides advice to district health boards, diabetes healthcare providers, and diabetes consumer support agencies on the effectiveness of healthcare services for people with diabetes within the district health board area.

Pacific Island peoples
The population identifying itself as Pacific Island ethnic origin, including people born in New Zealand and overseas.

Primary health care
The first level of contact that individuals, families, and the community have with the health system. The care given is therefore general (that is, not specialist), comprehensive (covers physical and mental well-being, and includes both preventative care as well as medical treatment), continuing (in that an individual often visits and establishes an ongoing relationship with a particular general practice), and accessible.

Primary health organisations
Not-for-profit provider organisations funded by district health boards to provide primary health care services for an enrolled population. They bring together general practitioners, nurses and other health professionals (such as Māori health workers, health promotion workers, dieticians, pharmacists, physiotherapists, psychologists and midwives) in the community to serve the needs of their enrolled populations. A primary health organisation provides services directly by employing staff or through its provider members.

The number of instances of a given disease or other condition in a population at a given time. It is usually described as a rate. Prevalence includes both new (incidence) and existing instances of a disease. It allows comparisons to be made over time and between different populations (as long as the rate is standardised to allow for different age structures in different populations).

Programme administrator
Refers to the organisation funded by a district health board to administer the “Get Checked” programme and maintain the diabetes register. This organisation may be a primary health organisation, an independent practitioners association, or a community organisation. Programme administrators collect data from general practitioners, enter it in a database (the diabetes register), analyse the data, and report the results to general practitioners. They also arrange for district health boards to pay general practitioners, provide general practitioners with resources for carrying out the annual check, and provide a summary of the data to local diabetes teams and the Ministry of Health.

Secondary care diabetes services
Services provided by medical specialists who generally do not have first contact with patients (for example, cardiologists, urologists, endocrinologists, opthalmologists). Generally patients first seek care from primary care providers and are then referred to secondary providers as needed.

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