Construction and use of mapping techniques to describe the geographical distribution of medication dispensing for the secondary prevention of atherosclerotic CVD in New Zealand: VIEW-2

N Z Med J. 2014 Aug 15;127(1400):70-80.

Abstract

Background: The Health Quality and Safety Commission (HQSC) is developing Atlases of Healthcare Variation in New Zealand. We were invited to create and map the sociogeographic distribution of medication dispensing patterns among people with atherosclerotic cardiovascular disease (CVD).

Methods: We developed two interactive online atlas 'templates' demonstrating geographical variations in CVD medication dispensing using InstantAtlas. Each template provides stratified results in tabular, graphical and map format. In the 'Standard' template proportions were mapped according to standard deviations from the mean, while the 'Advanced' template used a 'heat-map' classification to show DHB-level variations. Furthermore, we added commentaries describing the variations present and provided questions of potential interest for users.

Results: The Standard template was best suited for DHB-level variations relative to a specific age, gender, or ethnic group but less effective for showing comparisons between two groups (e.g. Maori and Pacific). By contrast, the fixed legend and 'radar plot' in the Advanced template highlighted variations in medication dispensing rates geographically and sociodemographically more effectively.

Conclusions: Geographical mapping of unwarranted variations in effective care requires careful consideration. Our experience from developing this CVD atlas is documented here for developers of other components of the Atlas of Healthcare Variation in New Zealand.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anticoagulants / therapeutic use
  • Antihypertensive Agents / therapeutic use
  • Atlases as Topic*
  • Coronary Artery Disease / epidemiology
  • Coronary Artery Disease / prevention & control*
  • Databases, Factual
  • Drug Prescriptions / statistics & numerical data*
  • Drug Therapy, Combination / statistics & numerical data
  • Ethnicity / statistics & numerical data
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Male
  • Middle Aged
  • New Zealand / epidemiology
  • Platelet Aggregation Inhibitors / therapeutic use
  • Secondary Prevention*
  • Software*

Substances

  • Anticoagulants
  • Antihypertensive Agents
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Platelet Aggregation Inhibitors