Lower rates are desirable as they signal less frequent severe self-harm.
The indicator captures both suicidal and non-suicidal self-harm within the hospitalization data where intentional self-harm was noted in the medical chart or abstract by a physician. Injuries coded as accidental or undetermined are not included in this indicator, even though a portion of these injuries may have been intentional. As such, this indicator underestimates the true number of hospitalizations for self-harm and should be considered a minimum rate of self-harm.
(Total number of discharges for self-harm for patients age 10 and older ÷ Total mid-year population age 10 and older) × 100,000 (age-adjusted)
Total mid-year population age 10 and older
Total number of self-harm hospitalizations for persons age 10 and older.
Unit of analysis for numerator cases: Episode of care. Episode building was performed among Discharge Abstract Database–Hospital Morbidity Database (DAD-HMDB) records to accommodate multiple abstracts within a single episode of care.
An episode of care refers to all contiguous inpatient hospitalizations in general and psychiatric hospitals. For episodes with transfers within or between facilities, transactions were linked regardless of diagnoses. To construct an episode of care, a transfer is assumed to have occurred if either of the following conditions is met:
- An acute care hospitalization occurs less than 7 hours after discharge from the previous acute care hospitalization, regardless of whether the transfer is coded;
- An acute care hospitalization occurs between 7 and 12 hours after discharge from the previous acute care hospitalization, and at least one of the hospitalizations has coded the transfer.
Comments
Patients in the Discharge Abstract Database–Hospital Morbidity Database (DAD-HMDB) and OMHRS with invalid postal codes will not be included in the numerator of any province but will be included in the all-Canada numerator. An exception to this is patients who are identified as homeless (DAD-HMDB: diagnosis code = Z59.0 or postal code = XX; OMHRS: residential status code = 8); these patients will be assigned to the province of the facility.