AIM:This study estimated diabetes prevalence and utilisation of healthcare services in Counties Manukau using routinely collected administrative data and compared estimates with findings for three other district health boards (DHBs) in close geographic proximity.METHOD:Records of subsidy claims for pharmaceuticals and laboratory investigations were linked to records in a national hospital admissions database to 'reconstruct' populations of four DHBs--Counties Manukau, Northland, Waitemata and Auckland. Individuals were included in reconstructed populations if they had health events recorded between January 2006 and December 2007. Diabetes cases were identified using an algorithm based on claims for monitoring tests and pharmaceuticals, as well as clinical codes for diabetes in hospital admissions.RESULTS:Reconstructed populations were only 6% lower than census population counts indicating that the vast majority of the population use health services in a two year period. The age- and sex-standardised prevalence of diabetes was 7.1% in Counties Manukau and 5.2% in the other three DHBs combined. Prevalence of diabetes was highest amongst Māori (10.6% in women and 12.2% in men) and Pacific peoples (15.0% for women and 13.5% for men). Maori diabetes cases had the highest hospital discharge rate of any ethnic group. Community pharmaceutical prescribing patterns and laboratory test frequency were similar between diabetes cases by ethnicity and deprivation.CONCLUSION:Estimates of diabetes prevalence using linkage of routinely collected administrative data were consistent with epidemiological surveys, suggesting that linkage of pharmaceutical and laboratory subsidy databases with hospital admissions data can be used as an alternative to traditional surveys for estimating the prevalence of some long-term conditions. This study demonstrated substantial differences in the prevalence of diabetes and in hospitalisation rates by ethnicity, but measures of community diabetes care were similar by ethnicity and deprivation.

Aims Nicotine replacement therapy (NRT) is a life-saving, cost-effective smoking cessation treatment that doubles the chances of long-term abstinence regardless of the amount of additional support provided. We investigate the proportion of working age people (age 15-64 years) in Counties Manukau District Health Board (CMDHB) who obtained at least one packet of subsidised NRT during 2007, and whether this varied by demographic characteristics.Method We linked health data in residents of CMDHB aged 15 to 64, using a cross sectional method, to estimate the odds of Maori and Pacific ethnic groups with high smoking prevalence accessing subsidised NRT during 2007 using logistic regression. Demographic variables such as age, gender, other ethnic groups, and socioeconomic deprivation (NZdep) were also included.Results Subsidised NRT was infrequently (proportion of 'ever users' 0.5%/year, or about 2.1% of smokers) claimed for in CMDHB in 2007. When adjusted for demographic variables, Pacific peoples were 60% less likely to claim NRT than European (odds ratio 0.34; 95% CI 0.29-0.41), despite a higher prevalence of smoking in the former group. An over four-fold increased use of NRT was observed in those aged 55 to 64 years compared to 15 to 25 year olds.Conclusion Dispensing of NRT is low overall in CMDHB. Lowest rates of treatment were observed in younger age groups, men and Pacific and Maori people. Programmes to increase uptake of such treatment in these groups are urgently needed.