The Canadian Institute for Health Information (CIHI) is pleased to provide its clients with the DAD Abstracting Manual, 2018–2019 for the Discharge Abstract Database and the NACRS Abstracting Manual, 2018–2019 for the National Ambulatory Care Reporting System. The DAD and NACRS Submission Manual, 2018–2019 is also available.

Accessing the manuals

Core Plan clients

Registered users who have the DAD/NACRS Abstracting Manual service:

  1. Log in and select DAD/NACRS Abstracting Manual.
  2. Select DAD or NACRS and 2018 from the drop-down menus and click Submit.

Registered users who do not have the DAD/NACRS Abstracting Manual service:

  1.  Log in to your CIHI profile and click Request Access: New/Revoke on your My Services page.
  2. Request access to the DAD/NACRS Abstracting Manual service. 

Non-registered users

  1. Create a CIHI profile.
  2. Log in to your CIHI profile and click Request Access: New/Revoke in the left-hand navigation menu.
  3. Request access to the DAD/NACRS Abstracting Manual service.

Get more information about accessing CIHI’s services, or contact CIHI’s Central Client Services team: or 613-241-5543.

All other clients

Clients who do not subscribe to the Core Plan can order the manuals online.

  1. Log in to eStore.
  2. From the Publications by Title list, select the manuals:
    • DAD Abstracting Manual

    • NACRS Abstracting Manual

    • DAD Submission Manual or NACRS Submission Manual (both links are for the same manual)

  3. Add the manuals to your cart.

Contact the Order Desk ( or 613-241-5543) if you do not have an account or require assistance with ordering.

2018–2019 abstracting manual changes

The 2018–2019 DAD and NACRS abstracting manuals each include a table of changes. These tables provide an overview of content changes that apply to all provinces and territories, as well as jurisdiction-specific updates.

Here are some highlights of changes to the 2018–2019 DAD and NACRS abstracting manuals:

Mental Health Indicators (DAD and NACRS): Several data elements were retired and others were created to make mental health data more comparable across Canada. Valid data elements mapped to jurisdictional local terms are available in the Provincial/Territorial Variations section of the manuals.

Care Transitions (DAD and NACRS): Standardized disposition codes and definitions are available in DAD and NACRS to better track patients throughout the continuum of care. We added new codes to capture emerging areas of interest such as medical assistance in dying (MAID), suicide and transfers to non-acute settings, including referral services such as community-based clinics and mental health services.

Hip and Knee Prosthesis Information (CJRR) (DAD only): Canadian Joint Replacement Registry (CJRR) information may now be collected in the DAD, which builds on the pan-Canadian arthroplasty hospitalization data already collected there. New Group 20 data elements can capture a maximum of 2 eligible CJRR interventions per abstract to record prosthesis information. Supplementary data collection resources are available in appendices A to C.

Blood Transfusion Information (DAD and NACRS): We expanded the list of blood products and components in the DAD and NACRS, making it more comprehensive and up to date. We also mandated the collection of the Blood Transfusion Indicator in all jurisdictions (DAD only).

Special Projects Data Collection Instructions (DAD and NACRS): This documentation has been removed from the manuals and is now found on the DAD/NACRS abstracting manuals web page.


Submit questions regarding the content of the DAD and NACRS abstracting manuals using CIHI’s eQuery tool. Select the Inpatient/Ambulatory abstracting and Education (DAD and NACRS) topic.

Submit feedback on changes to the DAD and NACRS abstracting manuals to the CAD team at with the subject “Manual feedback.”