May 30, 2019  — 

Canadians now have more information about home and community care and mental health and addictions services in their province or territory. Today, the Canadian Institute for Health Information (CIHI) released 3 new indicators that show how Canada’s health systems are faring when it comes to how many Canadians

  • Are hospitalized because of harm caused by substance use
  • Seek frequent emergency room (ER) care for help with mental health and/or addictions
  • Have their hospital stay extended because the right home and community care services and supports are not ready

These indicators are the first 3 of 12 chosen by the federal, provincial and territorial health ministries, in consultation with Canadians, to measure access to mental health and addictions services and to home and community care.

“The development of these new indicators has been a major collaborative effort between the ministries, system experts, CIHI and people with lived experiences. While it will take time for improvement efforts to be reflected in the indicators, health system decision-makers now have more tools to start discussions about how to target services and measure improvements, as well as to make better evidence-based decisions about how to deliver care to Canadians. CIHI is proud to be part of this effort to increase our knowledge of the mental health and addictions and home care sectors, which are very important services for all of us.” — David O’Toole, President and CEO, Canadian Institute for Health Information
“The Government of Canada has now signed bilateral agreements with all provinces and territories, setting out the details of ‎how federal investments to improve access to home and community care and mental health and addictions services will be spent. I believe it is important that Canadians see the results for investments in these priority areas. The indicators released today will serve as an initial set of invaluable metrics to help track improvements to access needed health services for all Canadians.” — Ginette Petitpas Taylor, Minister of Health
“All governments and system providers recognize the need to make home and community care and mental health services more accessible. The hospital-based indicators released today are a starting point to launch the discussion about access based on existing available data for these sectors. CIHI is committed to working with our partners to collect and report on additional data in community-based sectors.” — Kathleen Morris, Vice President, Research and Analysis, Canadian Institute for Health Information

This first year of results provides a baseline against which to track improvements over time. It will take time for new investments and renewed focus to have an impact on indicator results.

The indicator results are available in the Your Health System: In Brief web tool at the provincial and territorial levels. A companion report is available to provide context and assist with interpretation.

Indicator highlights

Hospital Stays for Harm Caused by Substance Use

This indicator measures how many hospital stays are a direct result of substance use, including alcohol, cannabis, cocaine and other drugs.

The first-year results, based on 2017–2018 data, show the following:

  • Every day, more than 400 Canadians were hospitalized due to harm caused by alcohol or drugs, more than the number of hospital stays for heart attacks and strokes combined.
  • 2 out of 3 of these hospital stays were for men.
  • About 40% of Canadians who had hospital stays caused by substance use also had a mental health condition such as anxiety, depression or schizophrenia.
  • Alcohol consumption was the top cause of hospitalization for harm attributed to substance use across all jurisdictions, accounting for more than half of these hospital stays. After alcohol, cannabis and opioids were among the top drugs leading to hospital stays for substance use in adults. For children and youth, these hospital stays were more likely to be caused by cannabis than by alcohol or other substances.

This hospital-based indicator represents only some of the services needed by individuals with substance use and addictions issues. Substance use and addictions are complex, and this indicator reflects long-term outcomes of public health efforts, and community and social services. It also reflects the needs of different populations, which are impacted by factors such as income, education, social networks, housing, and personal and/or intergenerational trauma.

Frequent Emergency Room Visits for Help With Mental Health and/or Addictions

This indicator measures how many Canadians visited the ER 4 or more times in 1 year. Many factors can influence these indicator results, including the needs and characteristics of the population as well as community-based health and social programs.     

In jurisdictions where ER data is available, the analysis found the following:

  • 1 in 10 Canadians who visited an ER for help with mental health and/or addictions did so at least 4 times in 1 year.
  • Half of these frequent ER visits were related to patients who were treated for both a mental health condition and an addiction.
  • Half of frequent ER users who visited for help with mental health and/or addictions were younger than 35.

Due to partial data coverage in some provinces and territories, data for this indicator is not yet comparable.

Hospital Stay Extended Until Home Care Services or Supports Ready

Home care is a vital service for many Canadians who need assistance but do not require hospital care. This indicator measures the number of days patients remain in hospital while waiting for home care services or supports to be ready.  

According to the data,

  • More than 90% of hospital patients had access to home care services as soon as they were ready to be discharged from hospital. But 1 in 12 had their stay extended because the services or supports were not ready.
    • This is the equivalent of 3 large hospitals filled each day with people who did not need hospital care.
  • A typical extended stay was 7 days or less, but 1 in 10 extended stays was 39 days or more.
  • Patients with extended hospital stays tend to be older women.

New results for health system performance indicators

In addition to the release of the 3 new indicators measuring access to mental health and addictions and home care services, CIHI has also updated the results for 31 existing health system performance indicators and contextual measures in the Your Health System web tool and Health Indicators e-Publication (CIHI’s Health Indicators Interactive Tool).

About Shared Health Priorities

Governments across Canada made a 10-year commitment that will lead to federal investments in the 2 priority areas of home and community care and mental health and addictions.

In 2017, the federal government made a commitment to invest $11 billion over 10 years to improve access in these 2 areas. The federal, provincial and territorial health ministers agreed to A Common Statement of Principles on Shared Health Priorities, which set out priority areas of action and guided the development of the bilateral agreements between the federal government and provinces and territories.

To support this program of work, the federal, provincial and territorial governments asked CIHI to select and develop a set of pan-Canadian indicators that focus on measuring access to the 2 priority areas.

In June 2018, Canada’s health ministers endorsed 12 indicators that had been recommended by CIHI and federal/provincial/territorial representatives.* These recommended indicators were informed by the advice of sector stakeholders, measurement experts and the public, and by published literature on the subject.

The endorsement of these indicators marked a significant step toward improving access to services and support in sectors that are clearly important to Canadians. Over the next 10 years, CIHI will work with governments across Canada to report annually on these indicators.

Note

* The federal government has agreed to an asymmetrical arrangement with Quebec, distinct from the Common Statement of Principles.

About CIHI

The Canadian Institute for Health Information (CIHI) is an independent, not-for-profit organization dedicated to providing essential health information to all Canadians.

CIHI works closely with federal, provincial and territorial partners and stakeholders throughout Canada to gather, package and disseminate information to inform policy, management, care and research, leading to better and more equitable health outcomes for all Canadians.

Health information has become one of society’s most valuable public goods. For 25 years, CIHI has set the pace on data privacy, security, accessibility and innovation to improve Canada’s health systems. 

CIHI: Better data. Better decisions. Healthier Canadians.

Associated links

Common Challenges, Shared Priorities: Measuring Access to Home and Community Care and to Mental Health and Addictions Services in Canada

Shared Health Priorities

A Common Statement of Principles on Shared Health Priorities

Media Backgrounder: Hospital Stays for Harm Caused by Substance Use

Media Backgrounder: Frequent Emergency Room Visits for Help With Mental Health and/or Addictions

Media Backgrounder: Hospital Stay Extended Until Home Care Services or Supports Ready

Your Health System: In Brief

Your Health System: In Depth

Your Health System: Complete list of indicators

Media contact

media@cihi.ca