The Development of the Municipal Registry of People with Diabetes in Porto Alegre, Brazil

TL;DR

This paper describes the creation of a diabetes registry in Porto Alegre, Brazil, using health system data to improve surveillance and care for people with diabetes.

Contribution

The paper introduces a method for developing a municipal diabetes registry in a low- to middle-income setting using integrated health databases.

Findings

The registry identified 73,185 people with diabetes in Porto Alegre, capturing 5.5% of the population.

Data from multiple health databases were merged using deterministic and probabilistic linkage methods.

The registry can provide metrics on diabetes treatment, complications, and mortality trends.

Abstract

Background/Objective: Diabetes registries that enhance surveillance and improve medical care are uncommon in low- and middle-income countries, where most of the diabetes burden lies. We aimed to describe the methodological and technical aspects adopted in the development of a municipal registry of people with diabetes using local and national Brazilian National Health System databases. Methods: We obtained data between July 2018 and June 2021 based on eight databases covering primary care, specialty and emergency consultations, medication dispensing, outpatient exam management, hospitalizations, and deaths. We identified diabetes using the International Classification of Disease (ICD), International Classification of Primary Care (ICPC), medications for diabetes, hospital codes for the treatment of diabetes complications, and exams for diabetes management. Results: After data processing and database merging using deterministic and probabilistic linkage, we identified 73,185 people with diabetes. Considering that 1.33 million people live in Porto Alegre, the registry captured 5.5% of the population. Conclusions: With additional data processing, the registry can reveal information on the treatment and outcomes of people with diabetes who are receiving publicly financed care in Porto Alegre. It will provide metrics for epidemiologic surveillance, such as the incidence, prevalence, rates, and trends of complications and causes of mortality; identify inadequacies; and provide information. It will enable healthcare providers to monitor the quality of care, identify inadequacies, and provide feedback as needed.

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