1.0 Health Status 2013

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1.0 Health Status

Health Conditions

1.1    Injury Hospitalization Rate

Definition

Age-standardized rate of acute care hospitalization due to injury resulting from the transfer of energy (excluding poisoning and other non-traumatic injuries), per 100,000 population.

Method of Calculation

(Total number of hospitalizations due to injury ∕ total mid-year population) × 100,000 (age adjusted)

Injury is identified by the first occurrence of the following external cause of injury codes with a diagnosis type of 9:

ICD-9

E800–E807, E810–E838, E840–E848, E880–E888, E890–E902, E906–E910, E913–E928, E953–E958, E960–E961, E963–E968, E970–E976, E978, E983–E988, E990–E998

ICD-10-CA

V01–V06, V09–V99, W00–W45, W46, W49–W60, W64–W70, W73–W77, W81, W83–W94, W99, X00–X06, X08–X19, X30–X39, X50, X52, X58, X59, X70–X84, X86, X91–X99, Y00–Y05, Y07–Y09, Y20–Y36

Interpretation

This indicator contributes to an understanding of the adequacy and effectiveness of injury prevention efforts, including public education, product development and use, community and road design, and prevention and treatment resources.

Standards/Benchmarks

Benchmarks have not been identified for this indicator.

Data Sources

National Trauma Registry (NTR), CIHI

Fichier des hospitalisations MED-ÉCHO, ministère de la Santé et des Services sociaux du Québec

Reference Period

April 1, 2011, to March 31, 2012

Comprehensiveness

Available for all provinces and territories.

Comments

Poisoning, adverse effects of drugs/medicine, choking, late effects and several other conditions do not meet the definition of trauma developed by the National Trauma Registry Advisory Committee and are therefore excluded. Newborns are also excluded.

Rates are not comparable with those appearing in the NTR annual report due to differences in the method of assigning cases to geography. The NTR data reflects region of hospitalization, while the indicator rates are based on region of residence.

 

1.2    Hospitalized Acute Myocardial Infarction Event Rate

Definition

Age-standardized rate of new acute myocardial infarction (AMI) events admitted to an acute care hospital, per 100,000 population age 20 and older. A new event is defined as a first-ever hospitalization for an AMI or a recurrent hospitalized AMI occurring more than 28 days after the admission for the previous event in the reference period.

Method of Calculation

(Total number of new AMI events for persons age 20 and older ∕ total mid-year population age
20 and older) × 100,000 (age-adjusted)

Numerator inclusion criteria:

1.  AMI present on admission
ICD-10-CA: I21, I22 coded as diagnosis type (1) or
2.  Age at admission 20 years and older

3.  Sex recorded as male or female

4.  Admission to an acute care institution

5.  Canadian resident

Numerator exclusion criteria:

1.  Records with an invalid health card number or date of birth

2.  Records with an invalid admission date

3.  AMI admissions within 28 days after the admission date of the previous AMI hospitalization
4.  Transfersi

Interpretation

AMI is one of the leading causes of morbidity and death. Measuring its occurrence in the population is important for planning and evaluating preventive strategies, allocating health resources and estimating costs. From a disease surveillance perspective, there are three groups of AMI events: non-diagnosed events, fatal events occurring outside the hospital and those admitted to acute care hospitals. Although AMIs admitted to a hospital do not reflect all AMIs in the community, this information provides a useful and timely estimate of the disease occurrence in the population.

Standards/Benchmarks

Benchmarks have not been identified for this indicator.

Data Sources

Discharge Abstract Database (DAD), CIHI

Fichier des hospitalisations MED-ÉCHO, ministère de la Santé et des Services sociaux du Québec

Reference Period

April 1, 2011, to March 31, 2012

Comprehensiveness

Available for all provinces and territories.

Comments

This indicator includes all new hospitalized AMI events in the reference period, encompassing first-ever and recurrent AMIs. A person may have more than one AMI event in the reference period. AMI events not admitted to an acute care hospital and in-hospital AMIs are not included in this indicator.

Myocardial infarction is labelled as acute when it has a stated duration of four weeks (28 days) or less in ICD-10-CA and eight weeks or less in ICD-9/ICD-9-CM. Therefore, a 28-day period to define a new AMI event is applicable only to the records coded in ICD-10-CA.

Bibliography

Heart and Stroke Foundation of Canada. The Growing Burden of Heart Disease and Stroke in
Canada 2003. Ottawa, Ont.: Heart and Stroke Foundation of Canada, 2003.

Manuel, D. G. et al. “How Many People Have Had a Myocardial Infarction? Prevalence
Estimated Using Historical Hospital Data.” BMC Public Health 7 (2007): p. 174.

 

1.3    Hospitalized Stroke Event Rate

Definition

Age-standardized rate of new stroke events admitted to an acute care hospital, per 100,000 population age 20 and older. A new event is defined as a first-ever hospitalization for stroke or
a recurrent hospitalized stroke occurring more than 28 days after the admission for the previous event in the reference period.

Method of Calculation

(Total number of new stroke events for persons age 20 and older ∕ total mid-year population age
20 and older) × 100,000 (age-adjusted)

Numerator inclusion criteria:

1.  Stroke present on admission
ICD-10-CA: I60–I64; ICD-9-CM: 430–432, 433–434 with fifth digit of 1, 436 coded as diagnosis type (1) or
2.  Age at admission 20 years and older

3.  Sex recorded as male or female

4.  Admission to an acute care institution

5.  Canadian resident

Numerator exclusion criteria:

1.  Records with an invalid health card number or date of birth

2.  Records with an invalid admission date

3.  Stroke admissions within 28 days after the admission date of the previous stroke hospitalization
4.  Transfersii

Interpretation

Stroke is one of the leading causes of long-term disability and death. Measuring its occurrence
in the population is important for planning and evaluating preventive strategies, allocating health resources and estimating costs. From a disease surveillance perspective, there are three groups of strokes: fatal events occurring out of the hospital, non-fatal stokes managed outside acute care hospitals and those admitted to an acute care facility. Although strokes admitted to a hospital do not reflect all stroke events in the community, this information provides a useful and timely estimate of the disease occurrence in the population.

Standards/Benchmarks

Benchmarks have not been identified for this indicator.

Data Source

Discharge Abstract Database (DAD), CIHI

Reference Period

April 1, 2011, to March 31, 2012

Comprehensiveness

Available for all provinces and territories, except Quebec. Rates for Quebec are not available due to differences in data collection.

Comments

This indicator includes all new hospitalized stroke events in the reference period, encompassing first-ever and recurrent strokes. A person may have more than one stroke event in the reference period. Stroke events not admitted to an acute care hospital and in-hospital strokes are not included in this indicator.

Note that identification of strokes resulting from occlusion of pre-cerebral arteries, included in this indicator, is not possible in the ICD-9 coding system.

Bibliography

Heart and Stroke Foundation of Canada. The Growing Burden of Heart Disease and Stroke in
Canada 2003. Ottawa, Ont.: Heart and Stroke Foundation of Canada, 2003.

Johansen, H. L. et al. “Incidence, Comorbidity, Case Fatality and Readmission of Hospitalized
Stroke Patients in Canada.” Canadian Journal of Cardiology 22 (2006): pp. 65–71.

Truelsen, T., R. Bonita and K. Jamrozik. “Surveillance of Stroke: A Global Perspective.” International
Journal of Epidemiology Suppl. 1 (2001): pp. S11–S16.

World Health Organization. WHO STEPS Stroke Manual: The WHO STEPwise Approach to
Stroke Surveillance. Geneva, Switzerland: WHO, 2006.

Deaths

1.4    Premature Mortality

Definitions

Premature mortality rate: Age-standardized rate of premature deaths per 100,000 population. Premature deaths are those that occur among individuals younger than age 75.

Potential years of life lost (PYLL): Age-standardized rate of PYLL per 100,000 population. PYLL is the number of years of potential life not lived when a person dies before age 75.

Method of Calculation

Premature mortality rate:

(Total number of deaths at age younger than 75 ∕ total mid-year population younger than age
75) × 100,000 (age adjusted)

Potential Years of Life Lost (PYLL):

(The sum of differences between 75 and age of deathiii ∕ total mid-year population younger than age 75) × 100,000 (age adjusted)

Interpretation

Premature mortality is an indicator of population health. It reflects deaths at younger ages and can be used to guide efforts on health promotion and disease prevention.

Standards/Benchmarks

Benchmarks have not been identified for this indicator.

Data Source

Vital Statistics—Death Database, Statistics Canada.

Reference Period

Rates are based on three years of pooled data: January 1, 2007, to December 31, 2009.

Comprehensiveness

Available for all provinces and territories.

 

i.    If a subsequent AMI admission occurs on the same day as or prior to the discharge date of a previous AMI admission, it is considered a transfer.

ii.   If a subsequent stroke admission occurs on the same day as or prior to the discharge date of a previous stroke admission, it is considered a transfer.

iii.  The PYLL values for each of the five-year age groups are available at www.statcan.gc.ca/pub/82-221-x/2011002/quality- qualite/qua2-eng.htm#a229.

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