Public Health Surveillance Approaches in Oregonʼs Medicaid Population

[Public health surveillance and role of administrative data]

BACKGROUND

Public health surveillance constitutes an important activity since it helps in identifying health needs through data collection, and contributes to decision making and actions by analyzing and interpreting data and communicating key results.

METHODS

This paper presents a discussion on the concept of public health surveillance, its objectives and its historical evolution. It deals with the importance of surveillance systems while describing their components and challenges. In addition, the authors point out the importance of administrative data as a relevant source for the surveillance of public health problems, particularly chronic diseases and risk factors.

RESULTS

This theoretical discussion leads to the proposal of a conceptual model for surveillance systems, which integrates implementation and evaluation.

CONCLUSION

This article provides a summary of the concept of public health surveillance and underlines the general aspects to be considered by the managers of surveillance systems. It also discusses the use of administrative data for surveillance.

Diabetes preventive care in Oregon's Medicaid population

The purpose of this study was to estimate the prevalence of diabetes in Oregon's adult Medicaid population and to compare the level of diabetes-related preventive care with the state's general population. Responses to telephone interviews conducted in 1999 among 2,770 randomly selected adult Medicaid beneficiaries and 7,229 Oregon residents were compared. Diabetes prevalence among adult Medicaid recipients (11.1% [95% Cl, 9.9% to 12.2%]) was more than twice that in the general population (4.7% [95% Cl, 4.2% to 5.3%]). During the year prior to the interview, adults with diabetes in the Medicaid and general populations reported performing the following preventive care, respectively: > or = 2 diabetes care visits (80%, 77%); foot examination (74%, 74%); dilated eye examination (73%, 68%); influenza vaccine (65%, 61%); self-monitored blood glucose daily (63%, 61%); pneumococcal vaccine (51%, 47%); regular aspirin use (48%, 53%); and awareness of Hemoglobin A1c (34%, 39%). Although the reported prevalence of diabetes in Oregon's Medicaid population is high, the prevalence of diabetes preventive care activities was similar to the state's general population. Nonetheless, specific services in both populations could be improved.