QIM 5: Proportion of regular clients with diabetes with an influenza immunisation status recorded in their GP record within the previous 15 months
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Overview
Influenza is a common disease of the respiratory tract. It affects people of all ages. In 2023, Influenza accounted for 19% of the total notifiable disease cases and has been the most common cause of notifiable disease hospitalisations in most years over the past decade, though highly variable from year to year. Influenza, which was the most common cause of notifiable disease deaths between 2014 and 2019, was recorded as the underlying cause of 305 deaths in 2022 (AIHW 2024e).
There are a number of groups who are at a higher risk of influenza and its complications. These groups experience higher illness and death associated with influenza than the rest of the population and patients with diabetes is one of the vulnerable population groups. Therefore, annual influenza vaccination is strongly recommended for patients with diabetes (ATAGI 2024).
While best practice guidelines recommend annual immunisation, a 15-month interval allows for cases when a client decides to receive a vaccine earlier than recommended (for example, from a pharmacy), or delay and wait for the release of an ‘enhanced’ vaccine (Department of Health 2020a).
Capture of results recorded outside of the general practice setting
Some patients may receive care from other practitioners in addition to a GP, including an endocrinologist, specialist physician, and/or other health care providers to safely manage their diabetes (RACGP 2020c). Results arising from clinical intervention conducted outside of the service that are known and recorded by the practice are included in the measure. Where immunisation was provided elsewhere but is not known to the practice, this is not captured in the report. For example, this might be where the vaccination providers’ information systems may not be compatible with the clinical information system (CIS) of the client’s usual general practice.
Other sources of relevant data
Data on the prevalence of long-term health conditions like diabetes are captured in the National Health Survey (NHS) conducted by the Australian Bureau of Statistics (ABS). There are other administrative data collections where the data from these client-provider interactions are captured, for example, Medicare Benefits Schedule (MBS), the National Diabetes Service Scheme (NDSS) register and the Australasian Paediatric Endocrine Groups (APEG) state and territory registers. There are other administrative data collections where data on influenza immunisation are captured, for example, the Australian Immunisation Register (AIR).
This indicator reports on the proportion of regular clients with Type 1 or Type 2 diabetes, or an undefined diabetes diagnosis, hereafter described as diabetes, who had an influenza immunisation status recorded in their GP record within the previous 15 months.
The QIM proportions summarised by the different extraction tools in use are also shown in the ‘Regional proportions’ bar charts for this measure. This illustrates the differences in how software providers have interpreted the technical specifications and coding of QIMs.
QIM5: Regional proportions
As of July 2024, nationally, 48.4% of regular clients with diabetes had an influenza immunisation status recorded in their GP record within the previous 15 months. This varied from 33.9% to 59.6% across PHNs, and between 46.7% and 51.0% across extraction tools.
Figure 38: Proportion of regular clients with diabetes (Type 1, Type 2, undefined) and an influenza immunisation status recorded in their GP record within the previous 15 months, by PHN, or extraction tool (ET), July 2024
This bar chart shows the proportion of regular clients with a recorded diagnosis of diabetes (Type 1, Type 2 and undefined) and an influenza immunisation status recorded in their GP record, by PHN for July 2024.
QIM 5: National proportions over time
Nationally, between July 2023 and July 2024, the proportion of regular clients with Type 1 or Type 2 diabetes, or an undefined diabetes diagnosis, who had an influenza immunisation status recorded in their GP record within the previous 15 months decreased by 3.5 percentage points, from 51.9% to 48.4%.
Figure 39: Proportion of regular clients with diabetes (Type 1, Type 2, undefined) and an influenza immunisation status recorded in their GP record within the previous 15 months, July 2023 to July 2024
This line chart shows the proportion of regular clients with a recorded diagnosis of diabetes (Type 1, Type 2 and undefined) and an influenza immunisation status recorded in their GP record, from July 2023 to July 2024.
QIM 5: National proportions by age and sex
As of July 2024, nationally, the proportion of regular clients with Type 1 or Type 2 diabetes, or an undefined diabetes diagnosis, who had an influenza immunisation status recorded in their GP record within the previous 15 months was:
- highest in the 65 years and over age group for both females (64.4%) and males (62.9%)
- lowest in the 25–34 years age group for both females (20.0%) and males (15.2%).
Figure 40: Proportion of regular clients with diabetes (Type 1, Type 2, undefined) and an influenza immunisation recorded in their GP record within the previous 15 months, by age and sex, July 2024
This bar chart shows the proportion of regular clients with a recorded diagnosis of diabetes (Type 1, Type 2 and undefined) and an influenza immunisation status recorded in their GP record, by age and sex for July 2024.
- Data for clients with diabetes are included if they have received an influenza vaccine within the previous 15 months.
- Clinical definitions for diabetes vary across CISs, as different coding schemes are used. This may lead to some variation in the number of clients who will be picked up by different systems (AIHW 2024i).
- Results arising from clinical intervention conducted outside of the service that are known and recorded by the service are included in the measure. Where immunisation was given elsewhere (for example, workplace or pharmacy) and the information is not recorded in the electronic record of the client’s usual general practice, then this may result in an apparent missing information.
- A client is classified as having diabetes, if they have Type 1 or Type 2 diabetes, or a diagnosis which indicates diabetes but does not specify between Type 1 or Type 2, listed as a diagnosis in their GP record. If a client had gestational diabetes but also has Type 1 or Type 2 diabetes, they are included in the measure.
- Clients are excluded from the measure if they:
- did not have the immunisation due to documented medical reasons (e.g. allergy), system reasons (vaccine not available) or client reasons (e.g. refusal),
- had secondary diabetes, gestational diabetes mellitus (GDM), previous GDM, impaired fasting glucose, impaired glucose tolerance,
- had results from measurements conducted outside of the service which were not available to the service.
- There are other administrative data collections where the data on influenza immunisation are captured for example, the Australian Immunisation Register (AIR).
AIHW (2024e) Australia’s Health 2024: Infectious and communicable diseases topic summary, AIHW, Canberra, accessed 17 July 2024.
AIHW (2024i) Aboriginal and Torres Strait Islander specific primary health care: results from the OSR and nKPI collections, AIHW, Canberra, accessed 10 July 2024.
ATAGI (Australian Technical Advisory Group on Immunisation) (2024) Australian Immunisation Handbook, Department of Health, Canberra, accessed 8 July 2024.
Department of Health (2020a) Practice Incentives Program Quality Improvement Measures User Guide for Primary Health Networks, Department of Health, Canberra, accessed 4 July 2024.
RACGP (2020c) Management of type 2 diabetes: A handbook for general practice, RACGP, East Melbourne, Victoria, accessed 5 July 2024.