Methodology
Name
Percutaneous Coronary Intervention Rate
Short/Other Names
PCI Rate
Description
This indicator measures the age-standardized rate of percutaneous coronary interventions (PCIs) performed on patients in acute care hospitals, same-day surgery facilities or catheterization laboratories, per 100,000 population age 18 and older.
For further details, please see the General Methodology Notes (PDF).
Rationale
In many cases, PCI serves as a non-surgical alternative to coronary artery bypass graft (CABG) surgery and is undertaken for the purpose of opening obstructed coronary arteries. While PCI encompasses several techniques, angioplasty is the procedure most frequently provided.
The choice of revascularization mode (PCI or CABG) depends on numerous factors, including physician preferences, availability of services and referral patterns, as well as differences in population health.
HSP Framework Dimension
Health system inputs and characteristics: Health system resources
Areas of Need
Not applicable
Targets/Benchmarks
Not applicable
Available Data Years
to (fiscal years)
Geographic Coverage
- All provinces/territories except Quebec
Reporting Level/Disaggregation
- National
- Province/Territory
- Region
Indicator Results
Web Tool:
Health Indicators e-Publication
Update Frequency
Every year
Latest Results Update Date
Updates
Not applicable
Description
(Total number of discharges for PCI for patients age 18 and older ÷ total mid-year population age 18 and older) × 100,000 (age adjusted)
Unit of Analysis: Single admission
Type of Measurement
Rate - Per 100,000
Denominator
Description:
Total mid-year population age 18 and older
Numerator
Description:
Total number of discharges for PCI for patients age 18 and older
Inclusions:
- PCIs performed on patients in acute care hospitals or same-day surgery facilities
- CCP: 48.02 or 48.03
- CCI: 1.IJ.50^, 1.IJ.57.GQ^^ (this code is used for 2017–2018 and earlier), 1.IJ.54.GQ-AZ (this code is used for 2006–2007 to 2008–2009 only), 1.IJ.57.GT (from 2018–2019), 1.IJ.57.GU (from 2018–2019)
- Age at admission 18 and older
- Sex recorded as male or female
- Admission to an acute care institution or same-day surgery facility (Facility Type Code = 1 or A)
Exclusions:
- Newborn, stillbirth or cadaveric donor records (Admission Category Code = N, R or S)
- PCI can be performed in designated cardiac centres only; therefore, procedures reported by facilities without on-site PCI services were excluded from the indicator calculation.
- Procedures coded as out of hospital or abandoned after onset (Intervention Status Attribute = A or OOH Indicator Flag = Y).
- 2018–2019 data onward: Discharges with medical assistance in dying (MAID) (Discharge Disposition Code = 73)
Method of Adjustment
Direct standardization
Standard Population
Canada 2011
Adjustment Applied
Age-adjusted
Geographic Assignment
Place of residence
Data Sources
- DAD
- NACRS
Caveats and Limitations
Rates for Quebec are not available due to differences in data collection.
Some residents in New Brunswick's Zone 4 and Zone 5 receive cardiac procedures in Quebec under a referral agreement between the 2 provinces. Due to differences in data collection in Quebec, data for New Brunswick residents undergoing PCI in Quebec is not available; thus the rates for these 2 regions are suppressed.
Trending Issues
Not applicable
References
Cardiac Care Network of Ontario Consensus Panel on Target Setting. Final Report and Recommendations (PDF). 2004.
Faris, P. D. et al. "Diagnostic Cardiac Catheterization and Revascularization Rates for Coronary Heart Disease." Canadian Journal of Cardiology 20 (2004): pp. 391-397.
Institute for Clinical Evaluative Sciences. Cardiovascular Health and Services in Ontario. Toronto, Ont.: ICES, 1999.
King, S. B. 3rd et al. "2007 Focused Update of the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention: A Report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines." Journal of the American College of Cardiology 51 (2008): pp. 172-209.
Smith, S. C. Jr. et al. "A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1993 Guidelines for Percutaneous Transluminal Coronary Angioplasty)." Journal of the American College of Cardiology 37 (2001): pp. 2215-2239.
Comments
PCI can be performed in designated cardiac centres only; therefore, procedures reported by facilities without on-site PCI services were excluded from the indicator calculation.