Indicator Metadata

NamePan-Canadian Age-Standardized (or Crude) Mental Illness Separations per 100,000 Population, by Province and/or Region
Short/Other Names

Not applicable

Description

Mental health and addiction separations (discharges or deaths) per 100,000 population (crude rate) by

–Province/territory
–Health region

Mental health and addiction separations (discharges or deaths) per 100,000 population (age-standardized rate) by

–Province/territory
–Health region

InterpretationThis indicator provides a measure of hospital utilization and may reflect differences in the health of the population and mental health service delivery models as well as variations in the availability and accessibility of specialized, residential and/or ambulatory and community-based health services.
HSP Framework Dimension

Health System Inputs and Characteristics: Health system resources

Areas of Need

Not applicable

Geographic Coverage

All provinces/territories

Reporting Level/Disaggregation

Province/Territory, Region

Indicator Results

https://apps.cihi.ca/mstrapp/asp/Main.aspx?Server=apmstrextprd_i&project=Quick%20Stats&uid=pce_pub_en&pwd=&evt=2048001&visualizationMode=0&documentID=D901470C442A5B26D6CC89B28B21C75F

Identifying Information
NamePan-Canadian Age-Standardized (or Crude) Mental Illness Separations per 100,000 Population, by Province and/or Region
Short/Other Names

Not applicable

Indicator Description and Calculation
Description

Mental health and addiction separations (discharges or deaths) per 100,000 population (crude rate) by

–Province/territory
–Health region

Mental health and addiction separations (discharges or deaths) per 100,000 population (age-standardized rate) by

–Province/territory
–Health region

Calculation: Description

Crude rate = (Number of separations for mental health or addictions ÷ Population estimate) × 100,000

Age-standardized rate is based on the crude rates for each age group and the application of population weights for each age group

Unit of analysis: Mental health and addiction separations

Calculation: Geographic Assignment

Place of residence

Calculation: Type of Measurement

Rate - Per 100,000

Calculation: Adjustment Applied

Age-adjusted

Calculation: Method of Adjustment

Direct Standardization
Standard Population:
Canada 2011

Denominator

Description:
Total mid-year population
Inclusions:
Total mid-year population

Numerator

Description:
Inpatient separations from general hospitals involving mental illness/addiction as the primary diagnosis and/or diagnosis category (for data extracted from the Ontario Mental Health Reporting System [OMHRS]).
Inclusions:
–Mental illness/addiction as the primary diagnosis and/or diagnosis category (for data extracted from OMHRS)

–Admission to a general hospital in Canada

The following codes were used for inpatient separations involving mental illness/addiction:

For 2011–2012 through 2013–2014
–DSM-IV-TR: 290–319, 607.84, 608.89, 625.0, 625.8 and 780.09
–ICD-9-CM: 290–319 and 648.40–648.44
–ICD-10-CA: F00–F99, G30, R41.0, R41.3 and O99.30

As of 2014–2015
–DSM-IV-TR: 290–319, 607.84, 608.89, 625.0, 625.8 and 780.09
–ICD-9-CM: 290–319 and 648.40–648.44
–ICD-10-CA: F00–F99, G30 and O99.30

For information on prior years, please contact the Mental Health and Addictions team at mentalhealth@cihi.ca.
Exclusions:
1. Newborns

2. Psychiatric hospital separations

Background, Interpretation and Benchmarks
Rationale

Having a solid picture of the proportions of separations and the trends over time provides health system planners and other decision-makers with information to plan care and evaluate the performance of their health care system.

Interpretation

This indicator provides a measure of hospital utilization and may reflect differences in the health of the population and mental health service delivery models as well as variations in the availability and accessibility of specialized, residential and/or ambulatory and community-based health services.

HSP Framework Dimension

Health System Inputs and Characteristics: Health system resources

Areas of Need

Not applicable

Targets/Benchmarks

Not applicable

References

Not applicable

Availability of Data Sources and Results
Data Sources

Demography division, Statistics Canada, HMHDB

Available Data Years

Type of Year:
Fiscal
First Available Year:
2003
Last Available Year:
2015

Geographic Coverage

All provinces/territories

Reporting Level/Disaggregation

Province/Territory, Region

Result Updates
Update Frequency

Every year

Indicator Results

Web Tool:
Quick Stats
URL: https://apps.cihi.ca/mstrapp/asp/Main.aspx?Server=apmstrextprd_i&project=Quick%20Stats&uid=pce_pub_en&pwd=&evt=2048001&visualizationMode=0&documentID=D901470C442A5B26D6CC89B28B21C75F

Updates

2014–2015: Two ICD-10-CA diagnosis codes were removed from the extraction criteria for the Discharge Abstract Database–Hospital Morbidity Database (DAD-HMDB), one of the data sources that populates the Hospital Mental Health Database (HMHDB). This decreased the volume of separations.

Quality Statement
Caveats and Limitations

As this indicator excludes psychiatric hospitals, it should not be construed to represent all mental health and addiction hospital separations in Canada.

Certain cells were suppressed for confidentiality reasons in accordance with CIHI's privacy policy. Totals exclude suppressed values.

Many factors contribute to the observed variations in the analysis of indicators at the provincial/territorial and regional levels. These include, but are not limited to, geography, population health, provincial and regional health service resources, and health services administration. It is important to consider these factors and the effect they may have on indicator results when conducting comparative analyses. The variation in results between provinces/territories or between health regions suggests systematic differences in

–Provincial/territorial or regional health policies, practices and resources
–Geography and urban/rural population distribution
–Environmental and socio-economic characteristics
–Types of patients served and acuity of illness
–The range of health services available beyond general and specialty psychiatric hospitals (such as community mental health services)
–Accessibility and awareness of alternative points of entry to the health system

The above list suggests a few of the factors that should be considered when making provincial/territorial and/or regional comparisons.

2011–2012: Additional ICD-10-CA diagnosis codes were added to the extraction criteria for the Discharge Abstract Database–Hospital Morbidity Database (DAD-HMDB), one of the data sources that populates the Hospital Mental Health Database (HMHDB). This increased the volume of separations.

Trending Issues

2011–2012: Additional ICD-10-CA diagnosis codes were added to the extraction criteria for the DAD-HMDB, one of the data sources that populates the HMHDB. This increased the volume of separations.

2014–2015: Two ICD-10-CA diagnosis codes were removed from the extraction criteria for the DAD-HMDB, one of the data sources that populates the HMHDB. This decreased the volume of separations.

Comments

Separations by year are based on the date of discharge, not the date of admission. As such, records with invalid discharge dates are not included.

The HMHDB is an event-based rather than a person-based database; individuals may be represented multiple times in the data.

For 2006–2007, 2007–2008, 2008–2009, 2009–2010, 2011–2012, 2012–2013, 2013–2014, 2014–2015 and 2015–2016, crude rate calculations at the provincial/territorial level are based on population estimates from Statistics Canada as of July 1, 2006, 2007, 2008, 2009, 2011, 2012, 2013, 2014 and 2015, respectively.

For 2010–2011, crude rate calculations at the provincial/territorial level are based on population estimates from Statistics Canada as of October 1, 2010.

For 2006–2007, 2007–2008, 2008–2009, 2009–2010, 2011–2012, 2012–2013, 2013–2014, 2014–2015 and 2015–2016, crude rate calculations at the regional level are based on population estimates from Statistics Canada as of July 1, 2006, 2007, 2008, 2009, 2011, 2012, 2013, 2014 and 2015, respectively.

For 2010–2011, crude rate calculations at the regional level are based on population estimates from Statistics Canada as of October 1, 2010.

Standardized rates are age-adjusted using a direct method of standardization based on the July 1, 2011, Canadian population. For data years prior to 2014–2015, rates were age-adjusted using a direct method of standardization based on the July 1, 1991, Canadian population.