Frequently Asked Questions

CIHI’s study, Wait Times Tables—A Comparison by Province, 2010, released in March 2010, reports on patient wait times for five priority areas identified by Canada’s first ministers in 2004: cancer treatment, cardiac care, sight restoration, joint replacement and diagnostic imaging. The most recent study shows that most patients are receiving care within recommended wait times for priority-area procedures, such as hip fracture repair, cataract surgery, cancer radiation therapy and hip replacements.

Patients in all 10 provinces wait longer for knee replacements than for any other priority procedure. However, for the three most populous provinces (Ontario, Quebec and British Columbia), at least three-quarters of patients received knee replacements within the recommended wait time of 26 weeks. On the other end, fewer than half of patients had their knee replaced within the benchmark in two provinces.

CIHI offers a comprehensive compensation package and a flexible benefit plan that allows employees to choose the coverage that is right for them. We offer competitive vacation time and an RRSP, as well as many opportunities for professional development and career training.

“I love working at CIHI. Every day, I look forward to being in such a friendly environment with caring management, wonderful colleagues, an amazing balance of fun and work, challenging tasks that stimulate me and the opportunity to improve my skills through training. Plus, I can see in everyday life how CIHI's databases and registries contribute to improving the health system in Canada and the health of Canadians.”

Mental illness affects a broad range of Canadians. Most people with compromised mental health are not homeless, and many people who are homeless have never been diagnosed with a mental illness. However, new analyses of CIHI data show that in 2005-2006, 35% of visits by homeless people to surveyed hospital emergency departments (mostly in Ontario) were due to mental and behavioral disorders. The most common type of disorder was psychoactive substance abuse, which accounted for 54% of visits (62% for homeless men and 30% for homeless women), followed by other psychotic disorders and delusional disorders (accounting for 20% of visits). Among non-homeless patients, injury, poisoning and consequences of external causes was the most common reason, accounting for 25% of ED visits.

Visit CIHI’s Accessibility Centre, where you’ll find the information you need.

Download CIHI’s accessibility request form and learn more about how CIHI is working to meet your needs and what is available in accessible formats.

Activity-based funding is a method of funding health-care providers (for example, acute-care hospitals, long-term care facilities, rehabilitation facilities) for the care and services they provide.

NACRS is the National Ambulatory Care Reporting System at the Canadian Institute for Health Information (CIHI). Ambulatory care is one of the largest-volume patient activities in Canada. Recognizing the need for data about this sector, CIHI developed the NACRS database. NACRS provides hospitals and community-based organizations with a standard data collection and reporting tool to capture data for ambulatory care visits, including day surgery, outpatient clinics and emergency departments. Data are available from 2001 onwards.

Just over 685,000 children made more than one million visits to EDs in Ontario in 2005–2006. Newborns and babies up to one year of age had the highest proportion of ED visits (802 per 1,000 children). This high visit rate reflects that 42.6% of newborns and babies up to one year of age came to the ED more than once in the year. The lowest rate of ED visits—279 per 1,000—was for children aged 10 to 14 years.

While most children made only one ED visit in the year, almost one-third (31.8%) made two or more visits. Almost one-quarter (23.5%) of children that made more than one visit to the ED in the year returned to the ED within 72 hours of their previous visit. Of these 218,106 children, we found that: • 34.1% were aged 1 to 4; • 45.7% had been triaged as requiring less- or non-urgent care at their initial visit; • 48.7% had registered between 4 p.m. and 12 a.m. during their initial visit; and • 12.6% had left the ED prior to their completing their initial visit.

ED patients are triaged based on a protocol which is designed to systematically ensure that those who need the most immediate care are assessed by physicians first. For our analyses, the five-level triage rating was used as a proxy to describe the severity of illness or acuity. More than half (55.1%) of children were triaged as requiring less urgent (level IV) or non-urgent (level V) care and less than 1% (0.3%) were triaged as requiring resuscitation (level I). While less than 1% of all children who visited EDs in Ontario were triaged as level I, PAHSCs saw the largest percentage of patients triaged as level I (0.6%). This was nearly three times the percentage seen in low-volume EDs (0.2%) and double that seen in high-volume EDs (0.3%).

Approximately 8 in 100 Canadians were hospitalized in acute care hospitals in 2006–2007, compared to 11 in 100 Canadians 12 years ago. This represents a decrease of 27.8% since 1995–1996 and a decrease of 4.2 % since 2005–2006 (figures adjusted for age and sex).

The Canadian Hospital Reporting Project (CHRP) is a national quality improvement initiative from the Canadian Institute for Health Information (CIHI). CHRP’s interactive web-based tool gives hospital decision-makers, policy-makers and Canadians access to indicator results for more than 600 facilities from every province and territory in Canada.

Most hospitals within the participating provinces will be included in CHRP, pending data availability and appropriate indicator volume thresholds.panels, a steering committee, core contacts in each province/territory and key stakeholders in health performance measurement.

The majority of acute care hospitals within each province and territory in Canada are participating in CHRP. Currently, this number is approximately 620 hospitals (95% of facilities providing acute care services in Canada).

An indicator is a single measure that represents a key dimension of health status, the health care system or related factors. Indicators can be used to identify potential opportunities for quality improvement and provide a basis for comparison between hospitals or between provincial, regional and national averages.

Several CIHI data sources have been used to produce clinical and financial indicators. Clinical data is drawn from administrative health care databases, such as the Discharge Abstract Database (DAD), the National Ambulatory Care Reporting System (NACRS), the Alberta Ambulatory Care Reporting System (AACRS) and the Hospital Morbidity Database (HMDB), as well as case mix grouping data. Financial data is drawn from the Canadian MIS Database (CMDB) and the DAD.

The median ALC length of stay in 2007–2008 was 10 days, which was similar to the previous two years. Some patients were classified as ALC for only a short time, while others spent several months in hospital as ALC after their acute treatment was complete. Fifteen percent of patients had only one or two ALC days, while 59% had more than a week and 20% had more than a month of ALC days. Some had very long ALC stays: 4% were more than 100 days. The long-stay patients did not differ from the shorter-stay patients on demographic variables (gender and age) but were more likely to be in the hospital for reasons related to dementia.

In 2007–2008, more than 50,000 Canadians were hospitalized outside of the province or territory that issued their health cards, representing 2% of all hospitalizations in Canada. According to a new study issued by the Canadian Institute for Health Information (CIHI), nearly one in four (23%) out-of-province/-territory hospitalizations involved childbirth or newborns. Almost two-thirds of those hospitalizations relating to pregnancy and childbirth were planned admissions.

Short-term readmissions represented the largest single category, with almost 12% of individuals being readmitted within 30 days of discharge from hospital. This is also demonstrated in Figure 1, which allows for an examination of the hospital readmission rate for schizophrenia over a one-year period. After one week, more than 4% of individuals diagnosed with schizophrenia had been readmitted to hospital for a mental illness. The proportion rises most quickly within the first 30 days of follow-up, and then more gradually to about 28% at 180 days and about 38% after one year.

Of the $21 billion spent on prescribed drugs in Canada in 2006, 46% was financed by the public sector, and 36% was funded by private insurers. The remaining $3.9 billion was paid directly out-of-pocket by Canadian households.

The NPDUIS Database design is flexible, allowing for change as stakeholder information needs evolve. The NPDUIS Database includes the following data: Claims data consisting of cost and payment information in relation to prescribed drugs. This information is used to measure and analyze the pattern of drugs use in Canada. Formulary data that identify how drugs are included on public drug programs in Canada. Drug Product data used to identify drug products in a standardized format. Plan Information provides an outline of a variety of administrative policies of the federal, provincial and territorial public drug plans or programs that may explain differences in drug utilization patterns across the country.

Diabetes is a prevalent and serious chronic condition and a growing problem. According to the World Health Organization, at least 171 million people worldwide have diabetes, and this figure is expected to more than double by 2030. Diabetes has high associated costs for the people who have it and for the health care system. Approximately 80% of adults with diabetes die from heart disease and stroke. Life expectancy for adults with diabetes is shorter by up to 15 years for type 1 diabetes and by 5 to 10 years for type 2 diabetes. A British Columbia study showed that adults with diabetes used, on average, 2.4 times the health resources of the general population.

Primary health care (PHC) has been called the foundation of Canada’s health system and is the most common type of health care that Canadians experience. PHC is, for most people, the first point of contact with the health care system, often through a family physician. It is where short-term health issues are resolved, where the majority of chronic health conditions are managed, where health promotion and education efforts are undertaken and where patients in need of more specialized services are connected with care. Dieticians, nurses, occupational therapists, physiotherapists, pharmacists, psychologists, social workers and other health care providers also deliver PHC services. PHC is often provided by interdisciplinary teams, and patients play a key role in maintaining their health between PHC visits.

Find out about electronic medical records: what are they and how do they benefit Canadians and their primary health care providers?

EMR content standards are specifications of key concepts and value sets that describe a subset of important data elements in EMRs. The draft standards involve more than 50 concepts for elements, such as age, diagnosis and procedure. All across Canada, EMRs are being enhanced to improve PHC. To support these efforts, there is a need to develop a set of EMR content standards for priority data elements to ensure that the necessary standardized information is available to improve access, quality, outcomes and chronic disease prevention and management.

The Cumulative Hospital Standardized Mortality Ratio (eHSMR) Report reflects the HSMR based on the All Cases model. It is available in PDF and tab-delimited ASCII formats.

Some types of adverse events are comparatively rare, but others occur more frequently. For example, adverse events related to medications and infections are more common than those related to blood transfusions or in-hospital fractures.

In general, Canadians are among the world’s most prosperous and healthy populations. However, not all Canadians are equally healthy. Systematic health disparities exist between different population groups. Health disparities are caused by a diverse set of factors. In general, these factors pertain to the conditions in which people are born, grow, live, work, age and eventually die. These are known as the determinants of heath and they include factors such as: • Income and social status; • Social support networks; • Education; • Employment and working conditions; • Social and physical environments; • Biology and genetic endowment; • Personal health practices and coping skills; • Healthy child development; • Health services; • Gender; and Culture.

The effects of socio-economic status (SES) are more prominent for some types of hospital admissions than for others. For example, a CIHI study of 15 census metropolitan areas over a three-year period (between 2003–2004 and 2005–2006) found: • Hospitalization rates for mental health in the low-SES group were 2.3 times those in the high-SES group (596 per 100,000 people compared to 256 per 100,000). Hospitalization rates for substance-related disorders in the low-SES group were 3.4 times those in the high-SES group. • Urban Canadians in low-SES groups were more than twice as likely to be hospitalized for chronic conditions that could potentially be treated in the community, known as ambulatory care sensitive conditions (ACSCs), than those in high-SES groups. For example, they were 2.4 times more likely to be hospitalized for diabetes and 2.7 times more likely to be hospitalized for chronic obstructive pulmonary disease (COPD). • Children from low-SES groups had hospitalization rates for asthma 56% higher than children from high-SES groups.

The hospital standardized mortality ratio (HSMR) is an important measurement tool for hospitals and health regions that compares a hospital's mortality rate with the overall average rate. Used widely in the United Kingdom and the United States, the ratio provides a starting point to assess mortality rates and identify areas for performance improvement. When tracked over time, the HSMR indicates how successful hospitals or health regions have been in reducing inpatient deaths and improving care.

It is necessary to re-start the assessment process with a new admission background form and full admission assessment when a resident moves from one facility to another, even if the period of time in the first facility is short. This practice is essential, as: • The RAI assessment process allows the care team at the new facility to fully assess the resident’s needs and provides a comprehensive picture of the resident. • There is evidence to suggest that relocation of a resident may have a meaningful impact on the status of the resident and thus, re-assessment is warranted. Assessments completed prior to the transfer should still be sent to the new facility to provide a reference point for the care team.

The Canadian Organ Replacement Register is a national database managed by the Canadian Institute for Health Information. CORR's mandate is to record and analyze the level of activity and outcomes of vital organ transplantation and renal dialysis activities.

CORR Frequently Asked Questions

While demographic shifts have played a role in driving health spending, the impact has been minimal. Contrary to public perception, population aging has been a modest cost driver overall, contributing an annual average growth of only 0.8%.

Health Care Cost Drivers: The Facts. looks at health spending from 1998 to 2008...

Canada's per person spending on prescribed and non-prescribed drugs remains among the highest in the OECD comparator countries

However, their share of total health expenditure has steadily declined. In 2008, hospitals were expected to account for 28.0% ($48.1 billion) of total health care spending, down from 30.7% in 1998 and 44.7% in 1975.

According to OECD Health Data 2008, the average number of physicians per 1,000 people in countries in the Organisation for Economic Co-operation and Development (OECD) increased from 2.4 in 1990 to 3.1 in 2006. Over the same period, the ratio in Canada remained steady at 2.1. The Canadian Institute for Health Information (CIHI) and Statistics Canada maintain the Canadian segment of the OECD Health Database, contributing national data on health care spending, health care services and the health status of the population.

1. What is a CIHI profile? A CIHI profile contains your contact and organization information, including your name, organization, address, telephone number and security questions. You need a CIHI profile to access and utilize CIHI’s online services and tools.

Yes. The Data Quality Framework assists in identifying the strengths and weaknesses of a database. The Framework will not assign your database with a mark of “pass” or “fail”. Instead, through a comprehensive assessment, it will help inform you, or the users of your data of the data quality of your databases and any limitations to be considered in analyzing the data.

The data request process involves five key steps: • Submission of inquiry to CIHI • Assessment by program area • Finalization of specifications, documentation, and approvals • Data processing and verification • Data release (and data destruction, for third party, record-level requests)

General Questions about the Data Request Process

Data Quality Framework Document Frequently Asked Questions

Answers to frequently asked questions about the MIS Standards

eDSS (Electronic Data Submission Service) Update & Frequently Asked Questions (FAQ)

Every province and territory across Canada collects health data—so what makes CIHI’s data different? Our data provides you with the ability to compare your data with other data collected from across the country—without the ability to compare you wouldn’t know where you stood. It also enables you to learn from leading practices.

At CIHI, our work is challenging and constantly evolving. We make it a priority to understand and celebrate the contribution of each and every one of our talented staff members. We are a respected name in the national dialogue about health and health care, and we’re poised for growth as governments continue to invest in making the system more effective.

In 2007, there were 258,000 registered nurses employed in nursing in Canada. After more than a decade of strong growth in the 1980s, the number of registered nurses decreased in the mid-1990s. This is reflective of a period of fiscal restraint that affected growth in the number of health care providers. The late 1990s represented a period of reinvestment in health care and, along with it, an increase in the number of registered nurses.

The age at which a student graduates from a regulated nursing program varies by profession. Across all three regulated nursing occupations—registered nursing, licensed practical nursing and registered psychiatric nursing—the average age at graduation increased over the last two decades.

Data for 2007 indicate that almost 15% of practising physiotherapists in Canada (excluding Nova Scotia, Quebec, British Columbia, the Northwest Territories and Nunavut) were educated outside of Canada. Data in regard to country of graduation show that these physiotherapists obtained their basic education in physiotherapy from a variety of industrialized and developing countries. The top three account for more than half of all internationally educated physiotherapists as follows: United Kingdom (31.5%), India (14.4%) and the United States (10.0%).

Access to a family physician often represents a point of entry to the health care system, as well as a way of ensuring continuity of care across the system for Canadians. This analysis examines the factors that can influence whether or not a family physician is accepting new patients, and how these factors differ among physicians working in urban and rural settings.