The Rule of Halves (RoH), stating that half of those with diabetes are diagnosed, half of those diagnosed receive care, half of those receiving care achieve treatment targets, and finally that half of those achieving targets also achieve desired outcomes, has not previously been assessed for diabetes in Copenhagen. As part of the quantitative mapping phase of the Cities Changing Diabetes project in Copenhagen, a RoH analysis was conducted. The results of this analysis are summarized below.
The figure shows that the ‘Halves’ rule does not generally apply for Copenhagen. On most of the levels, Copenhagen is doing better than simple halves. For example, the results indicate that almost three quarters of the true diabetes population are diagnosed and that almost all of those diagnosed with diabetes receive some form of care.
Although the analysis indicates that Copenhagen is doing better than the Rule of Halves when it comes to diabetes, there is still room for improvement. One out of four of those with diabetes have not been diagnosed, and although 98% receive some form of care, that does not necessarily reflect appropriate and timely care; our results show that the proportion ofpatients receiving screening for complications and clinical assessment according to national guidelines is ranging between 85% and 95%. Furthermore, the proportion achieving treatment targets is only around 40-60%, and only 60% of the diabetes population is achieving the desired outcomes in terms of no prevalent experiences of complications. Further, the RoH analysis showed that there are major socioeconomic differences in the prevalence of risk factors and occurrence of diabetes. Especially individuals with a low education, those without employment (i.e. unemployed or retired), of older age and non-western background has higher risk. However, the results also indicate that people with a short education and no employment more often had received information regarding preventive services and accepted offers of such services.