DAD/HMDB Childbirth Indicators by Place of Residence

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Quick Stats Metadata

Childbirth Indicators by Place of Residence

Highlights for these Quick Stats are available, by fiscal year, at: https://secure.cihi.ca/estore/productSeries.htm?pc=PCC226.

Metadata for each statistic follows the template below:

Name of Report

General description of the report of interest

Data Source(s)

Database(s) from which the data for the report of interest is derived

Available Statistics

Figures available in the report of interest (for example, crude primary C-section rate)

Available Breakdowns

All possible methods by which the data for the report of interest may be grouped (for example, national, provincial, or regional level)

Inclusions

Characteristics of records included in the data for the report of interest

Exclusions

Characteristics of records excluded from the data for the report of interest

Methodology

Analytical approach used to calculate the figures presented in the report of interest

Important Notes

Additional information that is relevant to the report of interest (for example, coverage in a particular fiscal year)

 

Name of Report

Epidural Rate for Vaginal Deliveries

Data Source(s)

  • Discharge Abstract Database (DAD), Canadian Institute for Health Information (CIHI)
  • Hospital Morbidity Database (HMDB), CIHI
  • Quebec data from 2006&eacirc;–2007 to 2009&eacirc;–2010 was sourced from the Fichier des hospitalisations MED-ÉCHO, ministère de la Sant© et des Services sociaux du Qu©bec. As of 2010&eacirc;–2011, Quebec data was sourced from the HMDB.

Available Statistics

Crude epidural rate for vaginal deliveries

Available Breakdowns

  • Discharge fiscal year (2001&eacirc;–2002 to 2011&eacirc;–2012)
  • National
  • Provincial
  • Regional

Inclusions

Discharges from acute care institutions in Canada
Denominator
ICD-9 delivery codes :

  • Any one diagnosis code of 640 to 676, with a fifth digit of 1 or 2 coded in any position OR
  • 650 coded in any position OR
  • V27 coded in any position

ICD-10-CA delivery codes (2001 and 2003 versions; used for 2001&eacirc;–2002 to 2005&eacirc;–2006 indicators) :

  • Any one diagnosis code of O10 to O16, O20 to O29, O30 to O46, O48, O60 to O75, O85 to O92, O95 or O98 to O99, with a sixth digit of 1 or 2 coded in any position OR
  • Z37 coded in any position

ICD-10-CA delivery codes (2006 and 2009 versions; used for 2006&eacirc;–2007 to 2011&eacirc;–2012 indicators):

  • Any one diagnosis code of O10 to O16, O21 to O29, O30 to O46, O48, O60 to O75, O85 to O92, O95 or O98 to O99, with a sixth digit of 1 or 2 coded in any position OR
  • Z37 coded in any position

Numerator (is a subset of the denominator)

CCP epidural codes :

  • Anesthetic Technique Code = 3 OR
  • A procedure code of 16.91 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure ( Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0)

CCI epidural codes :

  • Anesthetic Technique Code = 3 OR
  • A procedure code of 5.LD.20.HA-P1 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y)

Exclusions

CCP Caesarean section delivery codes :

  • Any one procedure code of 86.0 to 86.2, 86.8 or 86.9 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0)

CCI Caesarean section delivery codes :

  • A procedure code of 5.MD.60 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital ( Out-of-Hospital = Y)
  • Stillbirth records or newborns
  • Cadaveric donors
  • Non-female records
  • An abortive procedure:

    CCP :

    • Procedure code of 86.3, 86.4, 87.0, 87.1 or 87.2 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0) OR
    • Salpingectomy (partial) with removal of tubal pregnancy; removal of ectopic fetus from fallopian tube: a procedure code of 78.52 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0)

    CCI (2001 and 2003 versions; used for 2001&eacirc;–2002 to 2005&eacirc;–2006 indicators) :

    • Procedure code of 5.CA.88, 5.CA.89, 5.CA.90 or 5.CA.93 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y)

    CCI (2006 version; used for 2006&eacirc;–2007 to 2007&eacirc;–2008 indicators):

    • Procedure code of 5.CA.88, 5.CA.89 or 5.CA.93 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y) OR
    • An ICD-10-CA diagnosis code of O04 coded as most responsible diagnosis AND Z37 coded as type 3 diagnosis

    CCI (2006 and 2009 versions; used for 2008&eacirc;–2009 to 2011&eacirc;–2012 indicators):

    • Any one procedure code of 5.CA.20, 5.CA.24, 5.CA.88, 5.CA.89 or 5.CA.93 coded in any position that was not abandoned ( Status Attribute = A) or done out of hospital (Out-of-Hospital = Y) OR
    • An ICD-10-CA diagnosis code of O04 coded in any diagnosis field
  • Caesarean section:

Methodology

All records meeting the above inclusion/exclusion criteria.

Rate = (Number of vaginal deliveries where an epidural anesthetic was used) / (Number of vaginal deliveries) x 100

Important Notes

  1. Data for this indicator was restricted to those provinces and territories that had fully implemented the ICD-10-CA and CCI coding classification system. The exception is Quebec, which maintained the ICD-9 and CCP coding classification system up to 2005&eacirc;–2006. As of 2006&eacirc;–2007, Quebec began to submit in the ICD-10-CA and CCI coding classification system. As such, Quebec data prior to 2006&eacirc;–2007 may not be comparable with data from 2006&eacirc;–2007 onwards. As of 2006&eacirc;–2007, all provinces and territories were submitting in the ICD-10-CA and CCI coding classification system; for this reason, Canadian rates are provided only from 2006&eacirc;–2007 onwards.
  2. Results are presented for a patient&eacirc;’s region of residence, rather than the location of the facility where hospitalization occurred. For P.E.I. and the territories, the entire province/territory is included as a region. Health regions in Nova Scotia and Alberta have changed over time. The Postal Code Conversion File (PCCF/PCCF+) was used to assign patients to their region of residence.
  3. In order to provide a more stable rate estimate, only data from regions with a population of at least 75,000 (from 2001&eacirc;–2002 to 2005&eacirc;–2006) or 50,000 (as of 2006&eacirc;–2007) was reported. Additional indications for suppression were rate instability and under-reporting.
  4. Nunavut did not submit data to CIHI in 2002&eacirc;–2003.
  5. Data from Region 6 in New Brunswick in 2004&eacirc;–2005 was suppressed due to incomplete data submission. Data from this region was excluded from the provincial rate. Data from Peace Country in Alberta in 2006&eacirc;–2007 and 2008&eacirc;–2009 was also suppressed due to incomplete data submission.
  6. Data from 2005&eacirc;–2006 in Alberta and data from 2006&eacirc;–2007 in Newfoundland and Labrador was suppressed due to under-reporting of epidural use. Data from Chinook region in Alberta between 2001&eacirc;–2002 and 2005&eacirc;–2006 was also suppressed for this reason.
  7. Indicators for 2001&eacirc;–2002 to 2005&eacirc;–2006 were originally presented in the following CIHI report: Giving Birth in Canada: Regional Trends From 2001&eacirc;–2002 to 2005&eacirc;–2006.

 

Name of Report

Epidural Rate for All Deliveries

Data Source(s)

  • Discharge Abstract Database (DAD), Canadian Institute for Health Information (CIHI)
  • Hospital Morbidity Database (HMDB), CIHI
  • Quebec data from 2006&eacirc;–2007 to 2009&eacirc;–2010 was sourced from the Fichier des hospitalisations MED-ÉCHO, ministère de la Sant© et des Services sociaux du Qu©bec. As of 2010&eacirc;–2011, Quebec data was sourced from the HMDB.

Available Statistics

Crude epidural rate for all deliveries

Available Breakdowns

  • Discharge fiscal year (2001&eacirc;–2002 to 2011&eacirc;–2012)
  • National
  • Provincial
  • Regional

Inclusions

Discharges from acute care institutions in Canada
Denominator

ICD-9 delivery codes :

  • Any one diagnosis code of 640 to 676, with a fifth digit of 1 or 2 coded in any position OR
  • 650 coded in any position OR
  • V27 coded in any position

ICD-10-CA delivery codes (2001 and 2003 versions; used for 2001&eacirc;–2002 to 2005&eacirc;–2006 indicators) :

  • Any one diagnosis code of O10 to O16, O20 to O29, O30 to O46, O48, O60 to O75, O85 to O92, O95 or O98 to O99, with a sixth digit of 1 or 2 coded in any position OR
  • Z37 coded in any position

ICD-10-CA delivery codes (2006 and 2009 versions; used for 2006&eacirc;–2007 to 2011&eacirc;–2012 indicators):

  • Any one diagnosis code of O10 to O16, O21 to O29, O30 to O46, O48, O60 to O75, O85 to O92, O95 or O98 to O99, with a sixth digit of 1 or 2 coded in any position OR
  • Z37 coded in any position

Numerator (is a subset of the denominator)

CCP epidural codes :

  • Anesthetic Technique Code = 3 OR
  • A procedure code of 16.91 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure ( Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0)

CCI epidural codes :

  • Anesthetic Technique Code = 3 OR
  • A procedure code of 5.LD.20.HA-P1 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y)

Exclusions

  • Stillbirth records or newborns
  • Cadaveric donors
  • Non-female records
  • An abortive procedure:

    CCP :

    • Procedure code of 86.3, 86.4, 87.0, 87.1 or 87.2 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0) OR
    • Salpingectomy (partial) with removal of tubal pregnancy; removal of ectopic fetus from fallopian tube: a procedure code of 78.52 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0)

    CCI (2001 and 2003 versions; used for 2001&eacirc;–2002 to 2005&eacirc;– 2006 indicators) :

    • Procedure code of 5.CA.88, 5.CA.89, 5.CA.90 or 5.CA.93 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y)

    CCI (2006 version; used for 2006&eacirc;–2007 to 2007&eacirc;–2008 indicators):

    • Procedure code of 5.CA.88, 5.CA.89 or 5.CA.93 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y) OR
    • An ICD-10-CA diagnosis code of O04 coded as most responsible diagnosis AND Z37 coded as type 3 diagnosis

    CCI (2006 and 2009 versions; used for 2008&eacirc;–2009 to 2011&eacirc;–2012 indicators):

    • Any one procedure code of 5.CA.20, 5.CA.24, 5.CA.88, 5.CA.89 or 5.CA.93 coded in any position that was not abandoned ( Status Attribute = A) or done out of hospital (Out-of-Hospital = Y) OR
    • An ICD-10-CA diagnosis code of O04 coded in any diagnosis field

Methodology

All records meeting the above inclusion/exclusion criteria.

Rate = (Number of deliveries where an epidural anesthetic was used) / (Number of deliveries) x 100

Important Notes

  1. Data for this indicator was restricted to those provinces and territories that had fully implemented the ICD-10-CA and CCI coding classification system. The exception is Quebec, which maintained the ICD-9 and CCP coding classification system up to 2005&eacirc;–2006. As of 2006&eacirc;–2007, Quebec began to submit in the ICD-10-CA and CCI coding classification system. As such, Quebec data prior to 2006&eacirc;–2007 may not be comparable with data from 2006&eacirc;–2007 onwards. As of 2006&eacirc;–2007, all provinces and territories were submitting in the ICD-10-CA and CCI coding classification system; for this reason, Canadian rates are provided only from 2006&eacirc;–2007 onwards.
  2. Results are presented for a patient&eacirc;’s region of residence, rather than the location of the facility where hospitalization occurred. For P.E.I. and the territories, the entire province/territory is included as a region. Health regions in Nova Scotia and Alberta have changed over time. The Postal Code Conversion File (PCCF/PCCF+) was used to assign patients to their region of residence.
  3. In order to provide a more stable rate estimate, only data from regions with a population of at least 75,000 (from 2001&eacirc;–2002 to 2005&eacirc;–2006) or 50,000 (as of 2006&eacirc;–2007) was reported. Additional indications for suppression were rate instability and under-reporting.
  4. Nunavut did not submit data to CIHI in 2002&eacirc;–2003.
  5. Data from Region 6 in New Brunswick in 2004&eacirc;–2005 was suppressed due to incomplete data submission. Data from this region was excluded from the provincial rate. Data from Peace Country in Alberta in 2006&eacirc;–2007 and 2008&eacirc;–2009 was also suppressed due to incomplete data submission.
  6. Data from 2005&eacirc;–2006 in Alberta and data from 2006&eacirc;–2007 in Newfoundland and Labrador was suppressed due to under-reporting of epidural use. Data from Chinook region in Alberta between 2001&eacirc;–2002 and 2005&eacirc;–2006 was also suppressed for this reason.
  7. Indicators for 2001&eacirc;–2002 to 2005&eacirc;–2006 were originally presented in the following CIHI report: Giving Birth in Canada: Regional Trends From 2001&eacirc;–2002 to 2005&eacirc;–2006.

 

Name of Report

Assisted Delivery Rate (Overall) Among Vaginal Deliveries

Data Source(s)

  • Discharge Abstract Database (DAD), Canadian Institute for Health Information (CIHI)
  • Hospital Morbidity Database (HMDB), CIHI
  • Quebec data from 2006&eacirc;–2007 to 2009&eacirc;–2010 was sourced from the Fichier des hospitalisations MED-ÉCHO, ministère de la Sant© et des Services sociaux du Qu©bec. As of 2010&eacirc;–2011, Quebec data was sourced from the HMDB.

Available Statistics

Crude assisted delivery rate (overall) among vaginal deliveries

Available Breakdowns

  • Discharge fiscal year (2001&eacirc;–2002 to 2011&eacirc;–2012)
  • National
  • Provincial
  • Regional

Inclusions

Discharges from acute care institutions in Canada
Denominator

ICD-9 delivery codes :

  • Any one diagnosis code of 640 to 676, with a fifth digit of 1 or 2 coded in any position OR
  • 650 coded in any position OR
  • V27 coded in any position

ICD-10-CA delivery codes (2001 and 2003 versions; used for 2001&eacirc;–2002 to 2005&eacirc;–2006 indicators) :

  • Any one diagnosis code of O10 to O16, O20 to O29, O30 to O46, O48, O60 to O75, O85 to O92, O95 or O98 to O99, with a sixth digit of 1 or 2 coded in any position OR
  • Z37 coded in any position

ICD-10-CA delivery codes (2006 and 2009 versions; used for 2006&eacirc;–2007 to 2011&eacirc;–2012 indicators):

  • Any one diagnosis code of O10 to O16, O21 to O29, O30 to O46, O48, O60 to O75, O85 to O92, O95 or O98 to O99, with a sixth digit of 1 or 2 coded in any position OR
  • Z37 coded in any position

Numerator (is a subset of the denominator)

CCP assisted delivery codes :

  • Procedure code of 84.0, 84.1, 84.2, 84.3 or 84.7 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0)

CCI assisted delivery codes :

  • Any one procedure code of 5.MD.53.KL, 5.MD.53.KK, 5.MD.53.KN, 5.MD.53.KM, 5.MD.53.KJ, 5.MD.53.KH, 5.MD.53.KS or 5.MD.53.KP coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y) OR
  • A procedure code of 5.MD.54 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital ( Out-of-Hospital = Y) OR
  • A procedure code of 5.MD.55 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital ( Out-of-Hospital = Y)

Exclusions

CCP Caesarean section delivery codes :

  • Any one procedure code of 86.0 to 86.2, 86.8 or 86.9 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0)

CCI Caesarean section delivery codes :

  • A procedure code of 5.MD.60 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital ( Out-of-Hospital = Y)
  • Stillbirth records or newborns
  • Cadaveric donors
  • Non-female records
  • An abortive procedure:

    CCP :

    • Procedure code of 86.3, 86.4, 87.0, 87.1 or 87.2 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0) OR
    • Salpingectomy (partial) with removal of tubal pregnancy; removal of ectopic fetus from fallopian tube: a procedure code of 78.52 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0)

    CCI (2001 and 2003 versions; used for 2001&eacirc;–2002 to 2005&eacirc;– 2006 indicators) :

    • Procedure code of 5.CA.88, 5.CA.89, 5.CA.90 or 5.CA.93 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y)

    CCI (2006 version; used for 2006&eacirc;–2007 to 2007&eacirc;–2008 indicators):

    • Procedure code of 5.CA.88, 5.CA.89 or 5.CA.93 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y) OR
    • An ICD-10-CA diagnosis code of O04 coded as most responsible diagnosis AND Z37 coded as type 3 diagnosis

    CCI (2006 and 2009 versions; used for 2008&eacirc;–2009 to 2011&eacirc;–2012 indicators):

    • Any one procedure code of 5.CA.20, 5.CA.24, 5.CA.88, 5.CA.89 or 5.CA.93 coded in any position that was not abandoned ( Status Attribute = A) or done out of hospital (Out-of-Hospital = Y) OR
    • An ICD-10-CA diagnosis code of O04 coded in any diagnosis field
  • Caesarean section:

Methodology

All records meeting the above inclusion/exclusion criteria.

Rate = (Number of vaginal deliveries assisted by means of forceps extraction, vacuum extraction or a combination of the two) / (Number of vaginal deliveries) x 100

Important Notes

  1. Data for this indicator was restricted to those provinces and territories that had fully implemented the ICD-10-CA and CCI coding classification system. The exception is Quebec, which maintained the ICD-9 and CCP coding classification system up to 2005&eacirc;–2006. As of 2006&eacirc;–2007, Quebec began to submit in the ICD-10-CA and CCI coding classification system. As such, Quebec data prior to 2006&eacirc;–2007 may not be comparable with data from 2006&eacirc;–2007 onwards. As of 2006&eacirc;–2007, all provinces and territories were submitting in the ICD-10-CA and CCI coding classification system; for this reason, Canadian rates are provided only from 2006&eacirc;–2007 onwards.
  2. Results are presented for a patient&eacirc;’s region of residence, rather than the location of the facility where hospitalization occurred. For P.E.I. and the territories, the entire province/territory is included as a region. Health regions in Nova Scotia and Alberta have changed over time. The Postal Code Conversion File (PCCF/PCCF+) was used to assign patients to their region of residence.
  3. In order to provide a more stable rate estimate, only data from regions with a population of at least 75,000 (from 2001&eacirc;–2002 to 2005&eacirc;–2006) or 50,000 (as of 2006&eacirc;–2007) was reported. Additional indications for suppression were rate instability and under-reporting.
  4. Nunavut did not submit data to CIHI in 2002&eacirc;–2003.
  5. Data from Region 6 in New Brunswick in 2004&eacirc;–2005 was suppressed due to incomplete data submission. Data from this region was excluded from the provincial rate. Data from Peace Country in Alberta in 2006&eacirc;–2007 and 2008&eacirc;–2009 was also suppressed due to incomplete data submission.
  6. Indicators for 2001&eacirc;–2002 to 2005&eacirc;–2006 were originally presented in the following CIHI report: Giving Birth in Canada: Regional Trends From 2001&eacirc;–2002 to 2005&eacirc;–2006.

 

Name of Report

Assisted Delivery Rate (Vacuum Extraction) Among Vaginal Deliveries

Data Source(s)

  • Discharge Abstract Database (DAD), Canadian Institute for Health Information (CIHI)
  • Hospital Morbidity Database (HMDB), CIHI
  • Quebec data from 2006&eacirc;–2007 to 2009&eacirc;–2010 was sourced from the Fichier des hospitalisations MED-ÉCHO, ministère de la Sant© et des Services sociaux du Qu©bec. As of 2010&eacirc;–2011, Quebec data was sourced from the HMDB.

Available Statistics

Crude assisted delivery rate (vacuum extraction) among vaginal deliveries

Available Breakdowns

  • Discharge fiscal year (2001&eacirc;–2002 to 2011&eacirc;–2012)
  • National
  • Provincial
  • Regional

Inclusions

Discharges from acute care institutions in Canada
Denominator

ICD-9 delivery codes :

  • Any one diagnosis code of 640 to 676, with a fifth digit of 1 or 2 coded in any position OR
  • 650 coded in any position OR
  • V27 coded in any position

ICD-10-CA delivery codes (2001 and 2003 versions; used for 2001&eacirc;–2002 to 2005&eacirc;–2006 indicators) :

  • Any one diagnosis code of O10 to O16, O20 to O29, O30 to O46, O48, O60 to O75, O85 to O92, O95 or O98 to O99, with a sixth digit of 1 or 2 coded in any position OR
  • Z37 coded in any position

ICD-10-CA delivery codes (2006 and 2009 versions; used for 2006&eacirc;–2007 to 2011&eacirc;–2012 indicators):

  • Any one diagnosis code of O10 to O16, O21 to O29, O30 to O46, O48, O60 to O75, O85 to O92, O95 or O98 to O99, with a sixth digit of 1 or 2 coded in any position OR
  • Z37 coded in any position

Numerator (is a subset of the denominator)

 

CCP vacuum extraction codes :

  • A procedure code of 84.7 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure ( Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0)

CCI vacuum extraction codes :

  • A procedure code of 5.MD.54 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital ( Out-of-Hospital = Y)

Exclusions

  • Stillbirth records or newborns
  • Cadaveric donors
  • Non-female records
  • An abortive procedure:

    CCP :

    • Procedure code of 86.3, 86.4, 87.0, 87.1 or 87.2 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0) OR
    • Salpingectomy (partial) with removal of tubal pregnancy; removal of ectopic fetus from fallopian tube: a procedure code of 78.52 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0)

    CCI (2001 and 2003 versions; used for 2001&eacirc;–2002 to 2005&eacirc;– 2006 indicators) :

    • Procedure code of 5.CA.88, 5.CA.89, 5.CA.90 or 5.CA.93 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y)

    CCI (2006 version; used for 2006&eacirc;–2007 to 2007&eacirc;–2008 indicators):

    • Procedure code of 5.CA.88, 5.CA.89 or 5.CA.93 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y) OR
    • An ICD-10-CA diagnosis code of O04 coded as most responsible diagnosis AND Z37 coded as type 3 diagnosis

    CCI (2006 and 2009 versions; used for 2008&eacirc;–2009 to 2011&eacirc;–2012 indicators):

    • Any one procedure code of 5.CA.20, 5.CA.24, 5.CA.88, 5.CA.89 or 5.CA.93 coded in any position that was not abandoned ( Status Attribute = A) or done out of hospital (Out-of-Hospital = Y) OR
    • An ICD-10-CA diagnosis code of O04 coded in any diagnosis field

Denominator

CCP Caesarean section delivery codes :

  • Any one procedure code of 86.0 to 86.2, 86.8 or 86.9 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0)

CCI Caesarean section delivery codes :

  • A procedure code of 5.MD.60 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital ( Out-of-Hospital = Y)
  • Caesarean section:

Numerator (is a subset of the denominator)

CCP codes :

  • Forceps technique: Any one procedure code of 84.0, 84.1, 84.2 or 84.3 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital ( Intervention Suffix = 0)

CCI codes :

  • Forceps technique: Any one procedure code of 5.MD.53.KL, 5.MD.53.KK, 5.MD.53.KN, 5.MD.53.KM, 5.MD.53.KJ, 5.MD.53.KH, 5.MD.53.KS or5.MD.53.KP coded in any position that was not abandoned (Status Attribute = A) or done out of hospital ( Out-of-Hospital = Y) OR
  • Vacuum and forceps technique: A procedure code of 5.MD.55 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y)
  • Vaginal deliveries assisted by means of forceps technique or vacuum and forceps technique:

Methodology

All records meeting the above inclusion/exclusion criteria.
Rate = (Number of vaginal deliveries assisted by means of vacuum extraction only) / (Number of vaginal deliveries) x 100

Important Notes

  1. Data for this indicator was restricted to those provinces and territories that had fully implemented the ICD-10-CA and CCI coding classification system. The exception is Quebec, which maintained the ICD-9 and CCP coding classification system up to 2005&eacirc;–2006. As of 2006&eacirc;–2007, Quebec began to submit in the ICD-10-CA and CCI coding classification system. As such, Quebec data prior to 2006&eacirc;–2007 may not be comparable with data from 2006&eacirc;–2007 onwards. As of 2006&eacirc;–2007, all provinces and territories were submitting in the ICD-10-CA and CCI coding classification system; for this reason, Canadian rates are provided only from 2006&eacirc;–2007 onwards.
  2. Results are presented for a patient&eacirc;’s region of residence, rather than the location of the facility where hospitalization occurred. For P.E.I. and the territories, the entire province/territory is included as a region. Health regions in Nova Scotia and Alberta have changed over time. The Postal Code Conversion File (PCCF/PCCF+) was used to assign patients to their region of residence.
  3. In order to provide a more stable rate estimate, only data from regions with a population of at least 75,000 (from 2001&eacirc;–2002 to 2005&eacirc;–2006) or 50,000 (as of 2006&eacirc;–2007) was reported. Additional indications for suppression were rate instability and under-reporting.
  4. Nunavut did not submit data to CIHI in 2002&eacirc;–2003.
  5. Data from Region 6 in New Brunswick in 2004&eacirc;–2005 was suppressed due to incomplete data submission. Data from this region was excluded from the provincial rate. Data from Peace Country in Alberta in 2006&eacirc;–2007 and 2008&eacirc;–2009 was also suppressed due to incomplete data submission.
  6. Indicators for 2001&eacirc;–2002 to 2005&eacirc;–2006 were originally presented in the following CIHI report: Giving Birth in Canada: Regional Trends From 2001&eacirc;–2002 to 2005&eacirc;–2006.

 

Name of Report

Assisted Delivery Rate (Forceps) Among Vaginal Deliveries

Data Source(s)

  • Discharge Abstract Database (DAD), Canadian Institute for Health Information (CIHI)
  • Hospital Morbidity Database (HMDB), CIHI
  • Quebec data from 2006&eacirc;–2007 to 2009&eacirc;–2010 was sourced from the Fichier des hospitalisations MED-ÉCHO, ministère de la Sant© et des Services sociaux du Qu©bec. As of 2010&eacirc;–2011, Quebec data was sourced from the HMDB.

Available Statistics

Crude assisted delivery rate (forceps) among vaginal deliveries

Available Breakdowns

  • Discharge fiscal year (2001-2002 to 2011&eacirc;–2012)
  • National
  • Provincial
  • Regional

Inclusions

Discharges from acute care institutions in Canada
Denominator

ICD-9 delivery codes :

  • Any one diagnosis code of 640 to 676, with a fifth digit of 1 or 2 coded in any position OR
  • 650 coded in any position OR
  • V27 coded in any position

ICD-10-CA delivery codes (2001 and 2003 versions; used for 2001&eacirc;–2002 to 2005&eacirc;–2006 indicators) :

  • Any one diagnosis code of O10 to O16, O20 to O29, O30 to O46, O48, O60 to O75, O85 to O92, O95 or O98 to O99, with a sixth digit of 1 or 2 coded in any position OR
  • Z37 coded in any position

ICD-10-CA delivery codes (2006 and 2009 versions; used for 2006&eacirc;–2007 to 2011&eacirc;–2012 indicators):

  • Any one diagnosis code of O10 to O16, O21 to O29, O30 to O46, O48, O60 to O75, O85 to O92, O95 or O98 to O99, with a sixth digit of 1 or 2 coded in any position OR
  • Z37 coded in any position

Numerator (is a subset of the denominator)

CCP forceps extraction codes :

  • Procedure code of 84.0, 84.1, 84.2 or 84.3 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0)

CCI forceps extraction codes :

  • Any one procedure code of 5.MD.53.KL, 5.MD.53.KK, 5.MD.53.KN, 5.MD.53.KM, 5.MD.53.KJ, 5.MD.53.KH, 5.MD.53.KS or 5.MD.53.KP coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y)

Exclusions

  • Stillbirth records or newborns
  • Cadaveric donors
  • Non-female records
  • An abortive procedure:

    CCP :

    • Procedure code of 86.3, 86.4, 87.0, 87.1 or 87.2 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0) OR
    • Salpingectomy (partial) with removal of tubal pregnancy; removal of ectopic fetus from fallopian tube: a procedure code of 78.52 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0)

    CCI (2001 and 2003 versions; used for 2001&eacirc;–2002 to 2005&eacirc;– 2006 indicators) :

    • Procedure code of 5.CA.88, 5.CA.89, 5.CA.90 or 5.CA.93 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y)

    CCI (2006 version; used for 2006&eacirc;–2007 to 2007&eacirc;–2008 indicators):

    • Procedure code of 5.CA.88, 5.CA.89 or 5.CA.93 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y) OR
    • An ICD-10-CA diagnosis code of O04 coded as most responsible diagnosis AND Z37 coded as type 3 diagnosis

    CCI (2006 and 2009 versions; used for 2008&eacirc;–2009 to 2011&eacirc;–2012 indicators):

    • Any one procedure code of 5.CA.20, 5.CA.24, 5.CA.88, 5.CA.89 or 5.CA.93 coded in any position that was not abandoned ( Status Attribute = A) or done out of hospital (Out-of-Hospital = Y) OR
    • An ICD-10-CA diagnosis code of O04 coded in any diagnosis field

Denominator

CCP Caesarean section delivery codes :

  • Any one procedure code of 86.0 to 86.2, 86.8 or 86.9 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0)

CCI Caesarean section delivery codes :

  • A procedure code of 5.MD.60 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital ( Out-of-Hospital = Y)
  • Caesarean section:

Numerator (is a subset of the denominator)

CCP codes :

  • Vacuum technique: A procedure code of 84.7 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0)

CCI codes :

  • Vacuum technique: A procedure code of 5.MD.54 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y) OR
  • Vacuum and forceps technique: A procedure code of 5.MD.55 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y)
  • Vaginal deliveries assisted by means of vacuum technique or vacuum and forceps technique:

Methodology

All records meeting the above inclusion/exclusion criteria.
Rate = (Number of vaginal deliveries assisted by means of forceps extraction only) / (Number of vaginal deliveries) x 100

Important Notes

  1. Data for this indicator was restricted to those provinces and territories that had fully implemented the ICD-10-CA and CCI coding classification system. The exception is Quebec, which maintained the ICD-9 and CCP coding classification system up to 2005&eacirc;–2006. As of 2006&eacirc;–2007, Quebec began to submit in the ICD-10-CA and CCI coding classification system. As such, Quebec data prior to 2006&eacirc;–2007 may not be comparable with data from 2006&eacirc;–2007 onwards. As of 2006&eacirc;–2007, all provinces and territories were submitting in the ICD-10-CA and CCI coding classification system; for this reason, Canadian rates are provided only from 2006&eacirc;–2007 onwards.
  2. Results are presented for a patient&eacirc;’s region of residence, rather than the location of the facility where hospitalization occurred. For P.E.I. and the territories, the entire province/territory is included as a region. Health regions in Nova Scotia and Alberta have changed over time. The Postal Code Conversion File (PCCF/PCCF+) was used to assign patients to their region of residence.
  3. In order to provide a more stable rate estimate, only data from regions with a population of at least 75,000 (from 2001&eacirc;–2002 to 2005&eacirc;–2006) or 50,000 (as of 2006&eacirc;–2007) was reported. Additional indications for suppression were rate instability and under-reporting.
  4. Nunavut did not submit data to CIHI in 2002&eacirc;–2003.
  5. Data from Region 6 in New Brunswick in 2004&eacirc;–2005 was suppressed due to incomplete data submission. Data from this region was excluded from the provincial rate. Data from Peace Country in Alberta in 2006&eacirc;–2007 and 2008&eacirc;–2009 was also suppressed due to incomplete data submission.
  6. Indicators for 2001&eacirc;–2002 to 2005&eacirc;–2006 were originally presented in the following CIHI report: Giving Birth in Canada: Regional Trends From 2001&eacirc;–2002 to 2005&eacirc;–2006.

 

Name of Report

Total Caesarean Section Rate

Data Source(s)

  • Discharge Abstract Database (DAD), Canadian Institute for Health Information (CIHI)
  • Hospital Morbidity Database (HMDB), CIHI

Available Statistics

Crude total Caesarean section rate

Available Breakdowns

  • Discharge fiscal year (2001-2002 to 2005&eacirc;–2006)
  • National
  • Provincial
  • Regional

Inclusions

Discharges from acute care institutions in Canada
Denominator

ICD-9 delivery codes :

  • Any one diagnosis code of 640 to 676, with a fifth digit of 1 or 2 coded in any position OR
  • 650 coded in any position OR
  • V27 coded in any position

ICD-10-CA delivery codes :

  • Any one diagnosis code of O10 to O16, O20 to O29, O30 to O46, O48, O60 to O75, O85 to O92, O95 or O98 to O99, with a sixth digit of 1 or 2 coded in any position OR
  • Z37 coded in any position

Numerator (is a subset of the denominator)

CCP Caesarean section delivery codes :

  • Procedure code of 86.0 to 86.2, 86.8 or 86.9 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0)

CCI Caesarean section delivery codes :

  • A procedure code of 5.MD.60 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital ( Out-of-Hospital = Y)

Exclusions

  • Stillbirth records or newborns
  • Cadaveric donors
  • Non-female records
  • An abortive procedure:

    CCP :

    • Procedure code of 86.3, 86.4, 87.0, 87.1 or 87.2 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0) OR
    • Salpingectomy (partial) with removal of tubal pregnancy; removal of ectopic fetus from fallopian tube: a procedure code of 78.52 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0)

    CCI (2001 and 2003 versions; used for 2001&eacirc;–2002 to 2005&eacirc;– 2006 indicators) :

    • Procedure code of 5.CA.88, 5.CA.89, 5.CA.90 or 5.CA.93 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y)

Methodology

All records meeting the above inclusion/exclusion criteria.
Rate = (Number of Caesarean section deliveries) / (Number of deliveries) x 100

Important Notes

  1. Data for this indicator was restricted to those provinces and territories that had fully implemented the ICD-10-CA and CCI coding classification system. The exception is Quebec, which maintained the ICD-9 and CCP coding classification system up to 2005&eacirc;–2006.
  2. Results are presented for a patient&eacirc;’s region of residence, rather than the location of the facility where hospitalization occurred. For P.E.I. and the territories, the entire province/territory is included as a region. Health regions in Nova Scotia and Alberta have changed over time. The Postal Code Conversion File (PCCF/PCCF+) was used to assign patients to their region of residence.
  3. In order to provide a more stable rate estimate, only data from regions with a population of at least 75,000 (from 2001&eacirc;–2002 to 2005&eacirc;–2006) or 50,000 (as of 2006&eacirc;–2007) was reported. Additional indications for suppression were rate instability and under-reporting.
  4. Nunavut did not submit data to CIHI in 2002&eacirc;–2003.
  5. Data from Region 6 in New Brunswick in 2004&eacirc;–2005 was suppressed due to incomplete data submission. Data from this region was excluded from the provincial rate.
  6. Data on the Total Caesarean Section Rate from 2006&eacirc;–2007 onwards is available through the Health Indicators publication.
  7. Indicators for 2001&eacirc;–2002 to 2005&eacirc;–2006 were originally presented in the following CIHI report: Giving Birth in Canada: Regional Trends From 2001&eacirc;–2002 to 2005&eacirc;–2006.

 

 

 

 

Name of Report

Primary Caesarean Section Rate

Data Source(s)

  • Discharge Abstract Database (DAD), Canadian Institute for Health Information (CIHI)
  • Hospital Morbidity Database (HMDB), CIHI
  • Quebec data from 2006&eacirc;–2007 to 2009&eacirc;–2010 was sourced from the Fichier des hospitalisations MED-ÉCHO, ministère de la Sant© et des Services sociaux du Qu©bec. As of 2010&eacirc;–2011, Quebec data was sourced from the HMDB.

Available Statistics

Crude primary Caesarean section rate

Available Breakdowns

  • Discharge fiscal year (2001-2002 to 2011&eacirc;–2012)
  • National
  • Provincial
  • Regional

Inclusions

Discharges from acute care institutions in Canada
Denominator

ICD-9 delivery codes :

  • Any one diagnosis code of 640 to 676, with a fifth digit of 1 or 2 coded in any position OR
  • 650 coded in any position OR
  • V27 coded in any position

ICD-10-CA delivery codes (2001 and 2003 versions; used for 2001&eacirc;–2002 to 2005&eacirc;–2006 indicators) :

  • Any one diagnosis code of O10 to O16, O20 to O29, O30 to O46, O48, O60 to O75, O85 to O92, O95 or O98 to O99, with a sixth digit of 1 or 2 coded in any position OR
  • Z37 coded in any position

ICD-10-CA delivery codes (2006 and 2009 versions; used for 2006&eacirc;–2007 to 2011&eacirc;–2012 indicators):

  • Any one diagnosis code of O10 to O16, O21 to O29, O30 to O46, O48, O60 to O75, O85 to O92, O95 or O98 to O99, with a sixth digit of 1 or 2 coded in any position OR
  • Z37 coded in any position

Numerator (is a subset of the denominator)

CCP Caesarean section delivery codes :

  • Any one procedure code of 86.0 to 86.2, 86.8 or 86.9 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0)

CCI Caesarean section delivery codes :

  • A procedure code of 5.MD.60 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital ( Out-of-Hospital = Y)

Exclusions

ICD-9 previous Caesarean section delivery codes :

  • A diagnosis code of 654.2 coded in any position

ICD-10-CA previous Caesarean section delivery codes (2001, 2003 and 2006 versions) :

  • Any one diagnosis code of O34.201, O66.401 or O75.701 coded in any position

ICD-10-CA and CCI previous or repeat Caesarean section delivery codes (2009 version) :

  • Any one diagnosis code of O34.201, O66.401 or O75.701 coded in any position OR
  • A procedure code of 5.MD.60 coded in any position that was coded as a repeat (Status Attribute = N4 or N6)

Undefined Caesarean sections (new as of 2011&eacirc;–2012 indicators):

  • Diagnosis code of 5.MD.60 coded in any position coded with a Status Attribute of &eacirc;‘Unknown&eacirc;’ and without any one diagnosis code of O34.201, O66.401 or O75.701 coded in any position.
  • Stillbirth records or newborns
  • Cadaveric donors
  • Non-female records
  • An abortive procedure:

    CCP :

    • Procedure code of 86.3, 86.4, 87.0, 87.1 or 87.2 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0) OR
    • Salpingectomy (partial) with removal of tubal pregnancy; removal of ectopic fetus from fallopian tube: a procedure code of 78.52 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0)

    CCI (2001 and 2003 versions; used for 2001&eacirc;–2002 to 2005&eacirc;– 2006 indicators) :

    • Procedure code of 5.CA.88, 5.CA.89, 5.CA.90 or 5.CA.93 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y)

    CCI (2006 version; used for 2006&eacirc;–2007 to 2007&eacirc;–2008 indicators):

    • Procedure code of 5.CA.88, 5.CA.89 or 5.CA.93 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y) OR
    • An ICD-10-CA diagnosis code of O04 coded as most responsible diagnosis AND Z37 coded as type 3 diagnosis

    CCI (2006 and 2009 versions; used for 2008&eacirc;–2009 to 2011&eacirc;–2012 indicators):

    • Any one procedure code of 5.CA.20, 5.CA.24, 5.CA.88, 5.CA.89 or 5.CA.93 coded in any position that was not abandoned ( Status Attribute = A) or done out of hospital (Out-of-Hospital = Y) OR
    • An ICD-10-CA diagnosis code of O04 coded in any diagnosis field
  • Previous, repeat or undefined Caesarean section:

Methodology

All records meeting the above inclusion/exclusion criteria.
Rate = (Number of primary Caesarean section deliveries) / (Number of deliveries without a previous Caesarean section) x 100

Important Notes

  1. Changes in version 2009 of the ICD-10-CA and CCI coding classification system have resulted in changes to the methodology for deriving the Primary and Repeat Caesarean Section rates. As such, data from prior fiscal years, which used ICD-9/CCP and ICD-10/CCI versions 2001, 2003 and 2006 of the classification system, may not be comparable with data from 2009&eacirc;–2010 onwards.
  2. Data for this indicator was restricted to those provinces and territories that had fully implemented the ICD-10-CA and CCI coding classification system. The exception is Quebec, which maintained the ICD-9 and CCP coding classification system up to 2005&eacirc;–2006. As of 2006&eacirc;–2007, Quebec began to submit in the ICD-10-CA and CCI coding classification system. As such, Quebec data prior to 2006&eacirc;–2007 may not be comparable with data from 2006&eacirc;–2007 onwards. As of 2006&eacirc;–2007, all provinces and territories were submitting in the ICD-10-CA and CCI coding classification system; for this reason, Canadian rates are provided only from 2006&eacirc;–2007 onwards.
  3. Results are presented for a patient&eacirc;’s region of residence, rather than the location of the facility where hospitalization occurred. For P.E.I. and the territories, the entire province/territory is included as a region. Health regions in Nova Scotia and Alberta have changed over time. The Postal Code Conversion File (PCCF/PCCF+) was used to assign patients to their region of residence.
  4. In order to provide a more stable rate estimate, only data from regions with a population of at least 75,000 (from 2001&eacirc;–2002 to 2005&eacirc;–2006) or 50,000 (as of 2006&eacirc;–2007) was reported. Additional indications for suppression were rate instability and under-reporting.
  5. Nunavut did not submit data to CIHI in 2002&eacirc;–2003.
  6. Data from Region 6 in New Brunswick in 2004&eacirc;–2005 was suppressed due to incomplete data submission. Data from this region was excluded from the provincial rate. Data from Peace Country in Alberta in 2006&eacirc;–2007 and 2008&eacirc;–2009 was also suppressed due to incomplete data submission.
  7. Indicators for 2001&eacirc;–2002 to 2005&eacirc;–2006 were originally presented in the following CIHI report: Giving Birth in Canada: Regional Trends From 2001&eacirc;–2002 to 2005&eacirc;–2006.

 

Name of Report

Primary Caesarean Section Rate (Age <35 Years)

Data Source(s)

  • Discharge Abstract Database (DAD), Canadian Institute for Health Information (CIHI)
  • Hospital Morbidity Database (HMDB), CIHI
  • Quebec data from 2006&eacirc;–2007 to 2009&eacirc;–2010 was sourced from the Fichier des hospitalisations MED-ÉCHO, ministère de la Sant© et des Services sociaux du Qu©bec. As of 2010&eacirc;–2011, Quebec data was sourced from the HMDB.

Available Statistics

Crude primary Caesarean section rate (age < 35 years)

Available Breakdowns

  • Discharge fiscal year (2001-2002 to 2011&eacirc;–2012)
  • National
  • Provincial
  • Regional

Inclusions

Discharges from acute care institutions in Canada
Denominator

  • Patient Age <35 years

ICD-9 delivery codes :

  • Any one diagnosis code of 640 to 676, with a fifth digit of 1 or 2 coded in any position OR
  • 650 coded in any position OR
  • V27 coded in any position

ICD-10-CA delivery codes (2001 and 2003 versions; used for 2001&eacirc;–2002 to 2005&eacirc;–2006 indicators) :

  • Any one diagnosis code of O10 to O16, O20 to O29, O30 to O46, O48, O60 to O75, O85 to O92, O95 or O98 to O99, with a sixth digit of 1 or 2 coded in any position OR
  • Z37 coded in any position

ICD-10-CA delivery codes (2006 and 2009 versions; used for 2006&eacirc;–2007 to 2011&eacirc;–2012 indicators):

  • Any one diagnosis code of O10 to O16, O21 to O29, O30 to O46, O48, O60 to O75, O85 to O92, O95 or O98 to O99, with a sixth digit of 1 or 2 coded in any position OR
  • Z37 coded in any position

Numerator (is a subset of the denominator)

CCP Caesarean section delivery codes :

  • Any one procedure code of 86.0 to 86.2, 86.8 or 86.9 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0)

CCI Caesarean section delivery codes :

  • A procedure code of 5.MD.60 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital ( Out-of-Hospital = Y)

Exclusions

ICD-9 previous Caesarean section delivery codes :

  • A diagnosis code of 654.2 coded in any position

ICD-10-CA (2001, 2003 and 2006 versions) previous Caesarean section delivery codes :

  • Any one diagnosis code of O34.201, O66.401 or O75.701 coded in any position

ICD-10-CA and CCI previous or repeat Caesarean section delivery codes (2009 version) :

  • Any one diagnosis code of O34.201, O66.401 or O75.701 coded in any position OR
  • A procedure code of 5.MD.60 coded in any position that was coded as a repeat (Status Attribute = N4 or N6)

Undefined Caesarean sections (new as of 2011&eacirc;–2012 indicators):

  • Diagnosis code of 5.MD.60 coded in any position coded with a Status Attribute of &eacirc;‘Unknown&eacirc;’ and without any one diagnosis code of O34.201, O66.401 or O75.701 coded in any position.
  • Stillbirth records or newborns
  • Cadaveric donors
  • Non-female records
  • An abortive procedure:

    CCP :

    • Procedure code of 86.3, 86.4, 87.0, 87.1 or 87.2 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0) OR
    • Salpingectomy (partial) with removal of tubal pregnancy; removal of ectopic fetus from fallopian tube: a procedure code of 78.52 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0)

    CCI (2001 and 2003 versions; used for 2001&eacirc;–2002 to 2005&eacirc;– 2006 indicators) :

    • Procedure code of 5.CA.88, 5.CA.89, 5.CA.90 or 5.CA.93 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y)

    CCI (2006 version; used for 2006&eacirc;–2007 to 2007&eacirc;–2008 indicators):

    • Procedure code of 5.CA.88, 5.CA.89 or 5.CA.93 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y) OR
    • An ICD-10-CA diagnosis code of O04 coded as most responsible diagnosis AND Z37 coded as type 3 diagnosis

    CCI (2006 and 2009 versions; used for 2008&eacirc;–2009 to 2011&eacirc;–2012 indicators):

    • Any one procedure code of 5.CA.20, 5.CA.24, 5.CA.88, 5.CA.89 or 5.CA.93 coded in any position that was not abandoned ( Status Attribute = A) or done out of hospital (Out-of-Hospital = Y) OR
    • An ICD-10-CA diagnosis code of O04 coded in any diagnosis field
  • Previous, repeat or undefined Caesarean section:

Methodology

All records meeting the above inclusion/exclusion criteria.
Rate = (Number of primary Caesarean section deliveries) / (Number of deliveries without a previous Caesarean section, age <35 years) x 100

Important Notes

  1. Changes in version 2009 of the ICD-10-CA and CCI coding classification system have resulted in changes to the methodology for deriving the Primary and Repeat Caesarean Section rates. As such, data from prior fiscal years, which used ICD-9/CCP and ICD-10/CCI versions 2001, 2003 and 2006 of the classification system, may not be comparable with data from 2009&eacirc;–2010 onwards.
  2. Data for this indicator was restricted to those provinces and territories that had fully implemented the ICD-10-CA and CCI coding classification system. The exception is Quebec, which maintained the ICD-9 and CCP coding classification system up to 2005&eacirc;–2006. As of 2006&eacirc;–2007, Quebec began to submit in the ICD-10-CA and CCI coding classification system. As such, Quebec data prior to 2006&eacirc;–2007 may not be comparable with data from 2006&eacirc;–2007 onwards. As of 2006&eacirc;–2007, all provinces and territories were submitting in the ICD-10-CA and CCI coding classification system; for this reason, Canadian rates are provided only from 2006&eacirc;–2007 onwards.
  3. Results are presented for a patient&eacirc;’s region of residence, rather than the location of the facility where hospitalization occurred. For P.E.I. and the territories, the entire province/territory is included as a region. Health regions in Nova Scotia and Alberta have changed over time. The Postal Code Conversion File (PCCF/PCCF+) was used to assign patients to their region of residence.
  4. In order to provide a more stable rate estimate, only data from regions with a population of at least 75,000 (from 2001&eacirc;–2002 to 2005&eacirc;–2006) or 50,000 (as of 2006&eacirc;–2007) was reported. Additional indications for suppression were rate instability and under-reporting.
  5. Nunavut did not submit data to CIHI in 2002&eacirc;–2003.
  6. Data from Region 6 in New Brunswick in 2004&eacirc;–2005 was suppressed due to incomplete data submission. Data from this region was excluded from the provincial rate. Data from Peace Country in Alberta in 2006&eacirc;–2007 and 2008&eacirc;–2009 was also suppressed due to incomplete data submission.
  7. Indicators for 2001&eacirc;–2002 to 2005&eacirc;–2006 were originally presented in the following CIHI report: Giving Birth in Canada: Regional Trends From 2001&eacirc;–2002 to 2005&eacirc;–2006.

 

Name of Report

Primary Caesarean Section Rate (Age &eacirc;≥35 Years)

Data Source(s)

  • Discharge Abstract Database (DAD), Canadian Institute for Health Information (CIHI)
  • Hospital Morbidity Database (HMDB), CIHI
  • Quebec data from 2006&eacirc;–2007 to 2009&eacirc;–2010 was sourced from the Fichier des hospitalisations MED-ÉCHO, ministère de la Sant© et des Services sociaux du Qu©bec. As of 2010&eacirc;–2011, Quebec data was sourced from the HMDB.

Available Statistics

Crude primary Caesarean section rate (age &eacirc;≥35 years)

Available Breakdowns

  • Discharge fiscal year (2001-2002 to 2011&eacirc;–2012)
  • National
  • Provincial
  • Regional

Inclusions

Discharges from acute care institutions in Canada
Denominator

  • Patient Age &eacirc;≥35 years

ICD-9 delivery codes :

  • Any one diagnosis code of 640 to 676, with a fifth digit of 1 or 2 coded in any position OR
  • 650 coded in any position OR
  • V27 coded in any position

ICD-10-CA delivery codes (2001 and 2003 versions; used for 2001&eacirc;–2002 to 2005&eacirc;–2006 indicators) :

  • Any one diagnosis code of O10 to O16, O20 to O29, O30 to O46, O48, O60 to O75, O85 to O92, O95 or O98 to O99, with a sixth digit of 1 or 2 coded in any position OR
  • Z37 coded in any position

ICD-10-CA delivery codes (2006 and 2009 versions; used for 2006&eacirc;–2007 to 2011&eacirc;–2012 indicators):

  • Any one diagnosis code of O10 to O16, O21 to O29, O30 to O46, O48, O60 to O75, O85 to O92, O95 or O98 to O99, with a sixth digit of 1 or 2 coded in any position OR
  • Z37 coded in any position

Numerator (is a subset of the denominator)

CCP Caesarean section delivery codes :

  • Any one procedure code of 86.0 to 86.2, 86.8 or 86.9 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0)

CCI Caesarean section delivery codes :

  • A procedure code of 5.MD.60 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital ( Out-of-Hospital = Y)

Exclusions

ICD-9 previous Caesarean section codes :

  • A diagnosis code of 654.2 coded in any position

ICD-10-CA previous Caesarean section codes (2001, 2003 and 2006 versions) :

  • Any one diagnosis code of O34.201, O66.401 and O75.701 coded in any position

ICD-10-CA and CCI previous or repeat Caesarean section delivery codes (2009 version) :

  • Any one diagnosis code of O34.201, O66.401 or O75.701 coded in any position OR
  • A procedure code of 5.MD.60 coded in any position that was coded as a repeat (Status Attribute = N4 or N6)

Undefined Caesarean sections (new as of 2011&eacirc;–2012 indicators):

  • Diagnosis code of 5.MD.60 coded in any position coded with a Status Attribute of &eacirc;‘Unknown&eacirc;’ and without any one diagnosis code of O34.201, O66.401 or O75.701 coded in any position.
  • Stillbirth records or newborns
  • Cadaveric donors
  • Non-female records
  • An abortive procedure:

    CCP :

    • Procedure code of 86.3, 86.4, 87.0, 87.1 or 87.2 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0) OR
    • Salpingectomy (partial) with removal of tubal pregnancy; removal of ectopic fetus from fallopian tube: a procedure code of 78.52 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0)

    CCI (2001 and 2003 versions; used for 2001&eacirc;–2002 to 2005&eacirc;– 2006 indicators) :

    • Procedure code of 5.CA.88, 5.CA.89, 5.CA.90 or 5.CA.93 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y)

    CCI (2006 version; used for 2006&eacirc;–2007 to 2007&eacirc;–2008 indicators):

    • Procedure code of 5.CA.88, 5.CA.89 or 5.CA.93 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y) OR
    • An ICD-10-CA diagnosis code of O04 coded as most responsible diagnosis AND Z37 coded as type 3 diagnosis

    CCI (2006 and 2009 versions; used for 2008&eacirc;–2009 to 2011&eacirc;–2012 indicators):

    • Any one procedure code of 5.CA.20, 5.CA.24, 5.CA.88, 5.CA.89 or 5.CA.93 coded in any position that was not abandoned ( Status Attribute = A) or done out of hospital (Out-of-Hospital = Y) OR
    • An ICD-10-CA diagnosis code of O04 coded in any diagnosis field
  • Previous, repeat or undefined Caesarean section:

Methodology

All records meeting the above inclusion/exclusion criteria.
Rate = (Number of primary Caesarean section deliveries) / (Number of deliveries without a previous Caesarean section, age &eacirc;≥35 years) x 100

Important Notes

  1. Changes in version 2009 of the ICD-10-CA and CCI coding classification system have resulted in changes to the methodology for deriving the Primary and Repeat Caesarean Section rates. As such, data from prior fiscal years, which used ICD-9/CCP and ICD-10/CCI versions 2001, 2003 and 2006 of the classification system, may not be comparable with data from 2009&eacirc;–2010 onwards.
  2. Data for this indicator was restricted to those provinces and territories that had fully implemented the ICD-10-CA and CCI coding classification system. The exception is Quebec, which maintained the ICD-9 and CCP coding classification system up to 2005&eacirc;–2006. As of 2006&eacirc;–2007, Quebec began to submit in the ICD-10-CA and CCI coding classification system. As such, Quebec data prior to 2006&eacirc;–2007 may not be comparable with data from 2006&eacirc;–2007 onwards. As of 2006&eacirc;–2007, all provinces and territories were submitting in the ICD-10-CA and CCI coding classification system; for this reason, Canadian rates are provided only from 2006&eacirc;–2007 onwards.
  3. Results are presented for a patient&eacirc;’s region of residence, rather than the location of the facility where hospitalization occurred. For P.E.I. and the territories, the entire province/territory is included as a region. Health regions in Nova Scotia and Alberta have changed over time. The Postal Code Conversion File (PCCF/PCCF+) was used to assign patients to their region of residence.
  4. In order to provide a more stable rate estimate, only data from regions with a population of at least 75,000 (from 2001&eacirc;–2002 to 2005&eacirc;–2006) or 50,000 (as of 2006&eacirc;–2007) was reported. Additional indications for suppression were rate instability and under-reporting.
  5. Nunavut did not submit data to CIHI in 2002&eacirc;–2003.
  6. Data from Region 6 in New Brunswick in 2004&eacirc;–2005 was suppressed due to incomplete data submission. Data from this region was excluded from the provincial rate. Data from Peace Country in Alberta in 2006&eacirc;–2007 and 2008&eacirc;–2009 was also suppressed due to incomplete data submission.
  7. Indicators for 2001&eacirc;–2002 to 2005&eacirc;–2006 were originally presented in the following CIHI report: Giving Birth in Canada: Regional Trends From 2001&eacirc;–2002 to 2005&eacirc;–2006.

 

Name of Report

Repeat Caesarean Section Rate

Data Source(s)

  • Discharge Abstract Database (DAD), Canadian Institute for Health Information (CIHI)
  • Hospital Morbidity Database (HMDB), CIHI
  • Quebec data from 2006&eacirc;–2007 to 2009&eacirc;–2010 was sourced from the Fichier des hospitalisations MED-ÉCHO, ministère de la Sant© et des Services sociaux du Qu©bec. As of 2010&eacirc;–2011, Quebec data was sourced from the HMDB.

Available Statistics

Crude repeat Caesarean section rate

Available Breakdowns

  • Discharge fiscal year (2001-2002 to 2011&eacirc;–2012)
  • National
  • Provincial
  • Regional

Inclusions

Discharges from acute care institutions in Canada
Denominator

ICD-9 :

Delivery codes:

  • Any one diagnosis code of 640 to 676, with a fifth digit of 1 or 2 coded in any position OR
  • 650 coded in any position OR
  • V27 coded in any position

AND

Previous Caesarean section delivery codes:

  • A diagnosis code of 654.2 coded in any position

ICD-10-CA (2001 and 2003 versions; used for 2001&eacirc;–2002 to 2005&eacirc;–2006 indicators) :

Delivery codes:

  • Any one diagnosis code of O10 to O16, O20 to O29, O30 to O46, O48, O60 to O75, O85 to O92, O95 or O98 to O99, with a sixth digit of 1 or 2 coded in any position OR
  • Z37 coded in any position

AND

Previous Caesarean section delivery codes:

  • Any one diagnosis code of O34.201, O66.401 or O75.701 coded in any position

ICD-10-CA/CCI (2006 and 2009 versions; used for 2006&eacirc;–2007 to 2011&eacirc;–2012 indicators):

Delivery codes:

  • Any one diagnosis code of O10 to O16, O21 to O29, O30 to O46, O48, O60 to O75, O85 to O92, O95 or O98 to O99, with a sixth digit of 1 or 2 coded in any position OR
  • Z37 coded in any position

AND

Previous or repeat Caesarean section delivery codes:

  • Any one diagnosis code of O34.201, O66.401 or O75.701 coded in any position OR
  • For 2009 version only: A procedure code of 5.MD.60 coded in any position that was coded as a repeat (Status Attribute = N4 or N6)

Numerator (is a subset of the denominator)

CCP Caesarean section delivery codes :

  • Any one procedure code of 86.0 to 86.2, 86.8 or 86.9 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0)

CCI Caesarean section delivery codes :

  • A procedure code of 5.MD.60 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital ( Out-of-Hospital = Y)

Exclusions

  • Stillbirth records or newborns
  • Cadaveric donors
  • Non-female records
  • An abortive procedure:

    CCP :

    • Procedure code of 86.3, 86.4, 87.0, 87.1 or 87.2 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0) OR
    • Salpingectomy (partial) with removal of tubal pregnancy; removal of ectopic fetus from fallopian tube: a procedure code of 78.52 coded in any position that was not cancelled (Intervention Suffix = 8) or a previous procedure (Intervention Suffix = 9) or done out of hospital (Intervention Suffix = 0)

    CCI (2001 and 2003 versions; used for 2001&eacirc;–2002 to 2005&eacirc;–2006 indicators) :

    • Procedure code of 5.CA.88, 5.CA.89, 5.CA.90 or 5.CA.93 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y)

    CCI (2006 version; used for 2006&eacirc;–2007 to 2007&eacirc;–2008 indicators):

    • Procedure code of 5.CA.88, 5.CA.89 or 5.CA.93 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y) OR
    • An ICD-10-CA diagnosis code of O04 coded as most responsible diagnosis AND Z37 coded as type 3 diagnosis

    CCI (2006 and 2009 versions; used for 2008&eacirc;–2009 to 2011&eacirc;–2012 indicators):

    • Any one procedure code of 5.CA.20, 5.CA.24, 5.CA.88, 5.CA.89 or 5.CA.93 coded in any position that was not abandoned ( Status Attribute = A) or done out of hospital (Out-of-Hospital = Y) OR
    • An ICD-10-CA diagnosis code of O04 coded in any diagnosis field

Methodology

All records meeting the above inclusion/exclusion criteria.
Rate = (Number of repeat Caesarean section deliveries / (Number of deliveries with a previous Caesarean section) x 100

Important Notes

  1. Changes in version 2009 of the ICD-10-CA and CCI coding classification system have resulted in changes to the methodology for deriving the Primary and Repeat Caesarean Section rates. As such, data from prior fiscal years, which used ICD-9/CCP and ICD-10/CCI versions 2001, 2003 and 2006 of the classification system, may not be comparable with data from 2009&eacirc;–2010 onwards.
  2. Data for this indicator was restricted to those provinces and territories that had fully implemented the ICD-10-CA and CCI coding classification system. The exception is Quebec, which maintained the ICD-9 and CCP coding classification system up to 2005&eacirc;–2006. As of 2006&eacirc;–2007, Quebec began to submit in the ICD-10-CA and CCI coding classification system. As such, Quebec data prior to 2006&eacirc;–2007 may not be comparable with data from 2006&eacirc;–2007 onwards. As of 2006&eacirc;–2007, all provinces and territories were submitting in the ICD-10-CA and CCI coding classification system; for this reason, Canadian rates are provided only from 2006&eacirc;–2007 onwards.
  3. Results are presented for a patient&eacirc;’s region of residence, rather than the location of the facility where hospitalization occurred. For P.E.I. and the territories, the entire province/territory is included as a region. Health regions in Nova Scotia and Alberta have changed over time. The Postal Code Conversion File (PCCF/PCCF+) was used to assign patients to their region of residence.
  4. In order to provide a more stable rate estimate, only data from regions with a population of at least 75,000 (from 2001&eacirc;–2002 to 2005&eacirc;–2006) or 50,000 (as of 2006&eacirc;–2007) was reported. Additional indications for suppression were rate instability and under-reporting.
  5. Nunavut did not submit data to CIHI in 2002&eacirc;–2003.
  6. Data from Region 6 in New Brunswick in 2004&eacirc;–2005 was suppressed due to incomplete data submission. Data from this region was excluded from the provincial rate. Data from Peace Country in Alberta in 2006&eacirc;–2007 and 2008&eacirc;–2009 was also suppressed due to incomplete data submission.
  7. Indicators for 2001&eacirc;–2002 to 2005&eacirc;–2006 were originally presented in the following CIHI report: Giving Birth in Canada: Regional Trends From 2001&eacirc;–2002 to 2005&eacirc;–2006.

 

Name of Report

Low Birth Weight Rate (<2,500 Grams)

Data Source(s)

  • Discharge Abstract Database (DAD), Canadian Institute for Health Information (CIHI)
  • Hospital Morbidity Database (HMDB), CIHI
  • Quebec data from 2006&eacirc;–2007 to 2009&eacirc;–2010 was sourced from the Fichier des hospitalisations MED-ÉCHO, ministère de la Sant© et des Services sociaux du Qu©bec. As of 2010&eacirc;–2011, Quebec data was sourced from the HMDB.

Available Statistics

Crude low birth weight rate (<2,500 grams)

Available Breakdowns

  • Discharge fiscal year (2001-2002 to 2011&eacirc;–2012)
  • National
  • Provincial
  • Regional

Inclusions

Discharges from acute care institutions in Canada
Denominator

ICD-10-CA in-hospital birth codes (2006 and 2009 versions; used for 2006&eacirc;–2007 to 2011&eacirc;–2012 indicators only):

  • Any one diagnosis code of Z38.0, Z38.3 or Z38.6 coded in any position

Numerator (is a subset of the denominator)

  • Weight <2,500 grams

Exclusions

  • Non-newborn records
  • Cadaveric donors
  • Invalid birth weight (Weight = blank, 0000, 0001 or ZZZZ)

ICD-10-CA abortion or out-of-hospital birth codes (2006 and 2009 versions; used for 2006&eacirc;–2007 to 2011&eacirc;–2012 indicators only):

  • Any one diagnosis code of P96.4, Z38.1, Z38.2, Z38.4, Z38.5, Z38.7 or Z38.8 coded in any diagnosis field

Methodology

All records meeting the above inclusion/exclusion criteria.
Rate = (Number of live newborns with a birth weight less than 2,500 grams) / (Number of live newborns with a valid birth weight) x 100

Important Notes

  1. As of 2006&eacirc;–2007, all provinces and territories were submitting in the ICD-10-CA and CCI coding classification system; for this reason, Canadian rates are provided only from 2006&eacirc;–2007 onwards.
  2. Results are presented for a patient&eacirc;’s region of residence, rather than the location of the facility where hospitalization occurred. For P.E.I. and the territories, the entire province/territory is included as a region. Health regions in Nova Scotia and Alberta have changed over time. The Postal Code Conversion File (PCCF/PCCF+) was used to assign patients to their region of residence.
  3. In order to provide a more stable rate estimate, only data from regions with a population of at least 75,000 (from 2001&eacirc;–2002 to 2005&eacirc;–2006) or 50,000 (as of 2006&eacirc;–2007) was reported. Additional indications for suppression were rate instability and under-reporting.
  4. Nunavut did not submit data to CIHI in 2002&eacirc;–2003.
  5. Data from Region 6 in New Brunswick in 2004&eacirc;–2005 was suppressed due to incomplete data submission. Data from this region was excluded from the provincial rate. Data from Peace Country in Alberta in 2006&eacirc;–2007 and 2008&eacirc;–2009 was also suppressed due to incomplete data submission.
  6. Indicators for 2001&eacirc;–2002 to 2005&eacirc;–2006 were originally presented in the following CIHI report: Giving Birth in Canada: Regional Trends From 2001&eacirc;–2002 to 2005&eacirc;–2006.

 

Name of Report

Low Birth Weight Rate (<2,500 Grams, Excluding <500 Grams)

Data Source(s)

  • Discharge Abstract Database (DAD), Canadian Institute for Health Information (CIHI)
  • Hospital Morbidity Database (HMDB), CIHI
  • Quebec data from 2006&eacirc;–2007 to 2009&eacirc;–2010 was sourced from the Fichier des hospitalisations MED-ÉCHO, ministère de la Sant© et des Services sociaux du Qu©bec. As of 2010&eacirc;–2011, Quebec data was sourced from the HMDB.

Available Statistics

Crude low birth weight rate (<2,500 grams, excluding <500 grams)

Available Breakdowns

  • Discharge fiscal year (2001-2002 to 2011&eacirc;–2012)
  • National
  • Provincial
  • Regional

Inclusions

Discharges from acute care institutions in Canada
Denominator

ICD-10-CA in-hospital birth codes (2006 and 2009 versions; used for 2006&eacirc;–2007 to 2011&eacirc;–2012 indicators only):

  • Any one diagnosis code of Z38.0, Z38.3 or Z38.6 coded in any position

Numerator (is a subset of the denominator)

    • Weight <2,500 grams

Exclusions

  • Non-newborn records
  • Cadaveric donors
  • Weight <500 grams
  • Invalid birth weight (Weight = blank, 0000, 0001 or ZZZZ)

ICD-10-CA abortion or out-of-hospital birth codes (2006 and 2009 versions; used for 2006&eacirc;–2007 to 2011&eacirc;–2012 indicators only):

  • Any one diagnosis code of P96.4, Z38.1, Z38.2, Z38.4, Z38.5, Z38.7 or Z38.8 coded in any diagnosis field

Methodology

All records meeting the above inclusion/exclusion criteria.
Rate = (Number of live newborns with a birth weight between 500 grams and 2,499 grams, inclusive) / (Number of live newborns with a birth weight greater than or equal to 500 grams) x 100

Important Notes

  1. As of 2006&eacirc;–2007, all provinces and territories were submitting in the ICD-10-CA and CCI coding classification system; for this reason, Canadian rates are provided only from 2006&eacirc;–2007 onwards.
  2. Results are presented for a patient&eacirc;’s region of residence, rather than the location of the facility where hospitalization occurred. For P.E.I. and the territories, the entire province/territory is included as a region. Health regions in Nova Scotia and Alberta have changed over time. The Postal Code Conversion File (PCCF/PCCF+) was used to assign patients to their region of residence.
  3. In order to provide a more stable rate estimate, only data from regions with a population of at least 75,000 (from 2001&eacirc;–2002 to 2005&eacirc;–2006) or 50,000 (as of 2006&eacirc;–2007) was reported. Additional indications for suppression were rate instability and under-reporting.
  4. Nunavut did not submit data to CIHI in 2002&eacirc;–2003.
  5. Data from Region 6 in New Brunswick in 2004&eacirc;–2005 was suppressed due to incomplete data submission. Data from this region was excluded from the provincial rate. Data from Peace Country in Alberta in 2006&eacirc;–2007 and 2008&eacirc;–2009 was also suppressed due to incomplete data submission.
  6. Indicators for 2001&eacirc;–2002 to 2005&eacirc;–2006 were originally presented in the following CIHI report: Giving Birth in Canada: Regional Trends From 2001&eacirc;–2002 to 2005&eacirc;–2006.

 

Name of Report

Preterm Birth Rate (<37 Weeks Gestation)

Data Source(s)

  • Discharge Abstract Database (DAD), Canadian Institute for Health Information (CIHI)
  • Hospital Morbidity Database (HMDB), CIHI
  • Quebec data from 2007&eacirc;–2008 to 2009&eacirc;–2010 was sourced from the Fichier des hospitalisations MED-ÉCHO, ministère de la Sant© et des Services sociaux du Qu©bec. As of 2010&eacirc;–2011, Quebec data was sourced from the HMDB.

Available Statistics

Crude preterm birth rate (<37 weeks gestation)

Available Breakdowns

  • Discharge fiscal year (2007-2008 to 2011&eacirc;–2012)
  • National
  • Provincial
  • Regional

Inclusions

Discharges from acute care institutions in Canada
Denominator

ICD-10-CA in-hospital birth codes:

  • Any one diagnosis code of Z38.0, Z38.3 or Z38.6 coded in any position

Numerator (is a subset of the denominator)

  • Delivery Gestational Age <37 weeks

Exclusions

  • Non-newborn records
  • Cadaveric donors
  • Invalid gestational age (Delivery Gestational Age = blank, 99 or ZZ)

ICD-10-CA abortion or out-of-hospital birth codes:

  • Any one diagnosis code of P96.4, Z38.1, Z38.2, Z38.4, Z38.5, Z38.7 or Z38.8 coded in any diagnosis field

Methodology

All records meeting the above inclusion/exclusion criteria.
Rate = (Number of live newborns with a gestational age of less than 37 weeks) / (Number of live newborns with a valid gestational age) x 100

Important Notes

  1. The Preterm Birth Rate indicator is new in Quick Stats as of 2009&eacirc;–2010 and was retrospectively updated for 2007&eacirc;–2008 and 2008&eacirc;–2009. Data for prior fiscal years is unavailable.
  2. Results are presented for a patient&eacirc;’s region of residence, rather than the location of the facility where hospitalization occurred. For P.E.I. and the territories, the entire province/territory is included as a region. Health regions in Nova Scotia and Alberta have changed over time. The Postal Code Conversion File (PCCF/PCCF+) was used to assign patients to their region of residence.
  3. In order to provide a more stable rate estimate, only data from regions with a population of at least 50,000 was reported. Additional indications for suppression were rate instability and under-reporting.

 

Name of Report

Small-for-Gestational-Age (SGA) Rate

Data Source(s)

  • Discharge Abstract Database (DAD), Canadian Institute for Health Information (CIHI)
  • Hospital Morbidity Database (HMDB), CIHI
  • Quebec data from 2007&eacirc;–2008 to 2009&eacirc;–2010 was sourced from the Fichier des hospitalisations MED-ÉCHO, ministère de la Sant© et des Services sociaux du Qu©bec. As of 2010&eacirc;–2011, Quebec data was sourced from the HMDB.

Available Statistics

Crude SGA rate

Available Breakdowns

  • Discharge fiscal year (2007-2008 to 2011&eacirc;–2012)
  • National
  • Provincial
  • Regional

Inclusions

Discharges from acute care institutions in Canada
Denominator

ICD-10-CA in-hospital singleton birth code:

  • A diagnosis code of Z38.0 coded in any position

Numerator (is a subset of the denominator)

  • Weight <10th percentile for gestational age and gender category (refer to standard percentile charts by Kramer et al., 2001; see Important Note 1)

Exclusions

  • Non-newborn records
  • Cadaveric donors
  • Invalid birth weight (Weight = blank, 0000, 0001 or ZZZZ)
  • Invalid or out-of-range gestational age (Delivery Gestational Age = blank or ZZ or <22 weeks or >43 weeks)
  • Gender Code ≠ F or M

Multiple births:

  • Any newborn record (Entry Code = N with a Z38 diagnosis code) where two or more newborn records are born to the same mother (duplicate Maternal Newborn Chart Number) within 40 days of one another (based on Admission Date) in the same institution (Institution Number) OR
  • Any one ICD-10-CA multiple birth diagnosis code of Z38.3, Z38.4, Z38.5, Z38.6, Z38.7 or Z38.8 coded in any diagnosis field

ICD-10-CA abortion or other out-of-hospital birth codes:

  • Any one diagnosis code of P96.4, Z38.1 or Z38.2 coded in any diagnosis field

Methodology

All records meeting the above inclusion/exclusion criteria.
Rate = (Number of live singleton newborns classified as SGA at birth) / (Number of live singleton newborns with a valid birth weight, gestational age and gender) x 100

Important Notes

  1. Standard Canadian birth weights for gestational age by gender charts were used; see M. S. Kramer et al. A new and improvedpopulation-based Canadian reference for birth weight for gestational age. Pediatrics. 2001;108(2):e35. http://www.pediatrics.org/cgi/content/full/108/2/e35.
  2. The Small-for-Gestational-Age Rate indicator is new in Quick Stats as of 2009&eacirc;–2010 and was retrospectively updated for 2007&eacirc;–2008 and 2008&eacirc;–2009. Data for prior fiscal years is unavailable.
  3. Results are presented for a patient&eacirc;’s region of residence, rather than the location of the facility where hospitalization occurred. For P.E.I. and the territories, the entire province/territory is included as a region. Health regions in Nova Scotia and Alberta have changed over time. The Postal Code Conversion File (PCCF/PCCF+) was used to assign patients to their region of residence.
  4. In order to provide a more stable rate estimate, only data from regions with a population of at least 50,000 was reported. Additional indications for suppression were rate instability and under-reporting.

 

Contact Details

  1. For more information about the Discharge Abstract Database (DAD), please visit /CIHI-ext-portal/internet/en/document/types+of+care/hospital+care/acute+care/dad_metadata or send an email to cad@cihi.ca.
  2. For more information about the Hospital Morbidity Database (HMDB), please visit /CIHI-ext-portal/internet/en/document/types+of+care/hospital+care/acute+care/HMDB_METADATA or send an email to cad@cihi.ca.
  3. For assistance using Interactive CIHI data, please send an email to help@cihi.ca.
  4. All other inquiries can be directed to

Canadian Institute for Health Information
495 Richmond Road, Suite 600
Ottawa, ON K2A 4H6
Phone: (613) 241-7860
Fax: (613) 241-8120

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