This indicator shows the number and percent of people with diabetes undergoing a lower-limb amputation.
Diabetes is a major cause of non-traumatic amputations and is a strong indicator on the quality of care. Wide variation in rates may highlight disparities. Monitoring variations in amputation rates serves as an indicator of the quality and effectiveness of health care services, especially diabetes management. Many lower-limb amputations are preventable through early detection, proper management of diabetes, and timely interventions for foot ulcers and vascular issues. Understanding variations can help identify areas where preventive measures and interventions need to be strengthened.
People with diabetes recorded as having a lower-limb amputation
Numerator detail
Procedure (ICD10) Codes: 4433800, 4435800, 9055700, 4436100, 4436400, 4436401, 4436101, 4437000, 4437300, 4436700, 4436701, 4436702.
Note: Only one amputation per person in the VDR is reported in this indicator.
Numerator exclusions
Cancer and trauma amputations with following clinical codes (ICD-10-AM-VI) were excluded.
Trauma
Clinical code
Clinical code description
S78
Traumatic amputation of hip and thigh
S88
Traumatic amputation of lower leg
S98
Traumatic amputation of ankle and foot
T05.3
Traumatic amputation of both feet
T05.4
Traumatic amputation of one foot and other leg [any level, except foot]
T05.5
Traumatic amputation of both legs [any levels]
T05.6
Traumatic amputation of upper and lower limbs, any combination [any level]
T13.6
Traumatic amputation of lower limb, level unspecified
Primary lower-limb cancer
Clinical code
Clinical code description
C40.2
Malignant neoplasm of long bones of lower limb
C40.3
Malignant neoplasm of short bones of lower limb
C43.7
Malignant melanoma of lower limb, including hip
C49.2
Malignant neoplasm of connective and soft tissue of lower limb, including hip
Count of distinct master NHIs identified as having diabetes on the VDR.
Denominator exclusions
Note:
- Cancer and trauma amputations with following clinical codes (ICD-10-AM-VI) were excluded.
- Only one amputation per person in the VDR is reported in this indicator.
Disaggregation
For single map analysis: By year (2018‒22), age group (0‒14 years, 15‒24 years, 25‒44 years, 45‒64 years, 65‒74 years and 75+ years), gender (female and male), ethnic group (Māori, Pacific peoples, Indian and European/other) and Health New Zealand district of domicile.
For PHO analysis: By year (2022), age group (0‒14 years, 15‒24 years, 25‒44 years, 45‒64 years, 65‒74 years and 75+ years), gender (female and male), ethnic group (Māori, Pacific peoples, Indian and European/other), PHO most recently enrolled with (for the relevant year), PHO group (small, medium, medium‒large and large).
- Data is not presented where the number of people in the numerator was less than 10. This is to preserve confidentiality.
- Ethnicity data presented is prioritised ethnic group (Māori, Pacific peoples, Indian and European/other).
- For all indicators, individuals with missing values for any of the variables of interest (age, gender, ethnicity and district) are excluded completely. For instance, if there are any missing values for age, they are excluded from all analyses. This approach ensures a consistent denominator throughout the analyses.
- Demographic information is taken from the VDR.
Exclusions
- People who died during the year
- People not enrolled in a PHO