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Indicator Metadata

NamePan-Canadian Percentage of Total Days Stayed in General Hospitals for Mental Illness, by Province, Diagnosis Category, Sex and/or Age Group
Short/Other Names

Not applicable

DescriptionPercentage of total days stayed in hospital for mental illness/addiction out of all general hospital separations (discharges or deaths) by
–Jurisdiction (province/territory)
–Age group
–Sex
–Diagnosis category
InterpretationThis indicator provides descriptive information about lengths of stay for mental illness inpatient separations in Canada stratified by diagnostic, geographic and demographic characteristics.
HSP Framework Dimension

Health System Inputs and Characteristics: Health system resources

Areas of Need

Not applicable

Geographic Coverage

All provinces/territories

Reporting Level/Disaggregation

National, Province/Territory

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 Percentage of Total Days Stayed in General Hospitals for Mental Illness, by Province, Diagnosis Category, Sex and/or Age Group
Short/Other Names

Not applicable

Indicator Description and Calculation
DescriptionPercentage of total days stayed in hospital for mental illness/addiction out of all general hospital separations (discharges or deaths) by
–Jurisdiction (province/territory)
–Age group
–Sex
–Diagnosis category
Calculation: DescriptionPercentage of Total Days Stayed in Hospital for Mental Illness/Addiction = Total days stayed in general hospital for mental illness/addiction divided by Total days stayed in general hospital for mental illness/addiction and non–mental illness/addiction diagnoses, by grouping (such as age, sex, province or diagnosis category) multiplied by 100
Calculation: Geographic Assignment

Place of service

Calculation: Type of Measurement

Percentage or proportion

Calculation: Adjustment Applied

None

Calculation: Method of Adjustment

None

Denominator

Description:
Total days stayed in hospital for inpatient separations from general hospitals involving mental illness/addiction and non–mental illness/addiction diagnoses
Inclusions:
1. Admission to a general hospital in Canada
Exclusions:
1. Newborns

2. Psychiatric hospital separations

Numerator

Description:
Total days stayed in hospital for 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:
1. Admission to a general hospital in Canada

2. Sex recorded as male or female for analyses with breakdown by sex

3. Valid age recorded for analyses with breakdown by age

4. Mental illness/addiction as the primary diagnosis and/or diagnosis category (for data extracted from OMHRS)

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

Average and total days stayed provide measures 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.

Interpretation

This indicator provides descriptive information about lengths of stay for mental illness inpatient separations in Canada stratified by diagnostic, geographic and demographic characteristics.

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

DAD, HMDB, HMHDB, OMHRS

Available Data Years

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

Geographic Coverage

All provinces/territories

Reporting Level/Disaggregation

National, Province/Territory

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 and consequently had an impact on the total days stayed.

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.

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 and consequently had an impact on the total days stayed.

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 and consequently had an impact on the total days stayed.

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.

Length of stay includes days stayed that occurred prior to the fiscal year of separation.

–If Admission Date is missing or invalid, then Length of Stay (LOS) is not calculated and is set to missing.
–If Discharge Date is missing or invalid, then LOS is not calculated and is set to missing.
–Records with a missing LOS are excluded from LOS analyses.
–Length of Stay = Discharge Date minus Admission Date.
–Where Discharge Date = Admission Date, the LOS is set to 1.
–Service interruptions and alternate level of care (ALC) days are included if they occurred during the stay.
–Days stayed is equivalent to LOS.