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Indicator Metadata

NameMental Illness Hospitalization
Short/Other Names

Not applicable

Description

The indicator measures the age-standardized rate of separations from general hospitals through discharge or death following a hospitalization for a selected mental illness,* per 100,000 population.

Note
*The mental illnesses selected for this indicator are substance-related disorders; schizophrenia, delusional and non-organic psychotic disorders; mood/affective disorders; anxiety disorders; and selected disorders of adult personality and behaviour.

For further details, please see the General Methodology Notes.

InterpretationLower rates are desirable.
HSP Framework Dimension

Health System Outputs: Person-centred

Areas of Need

Living With Illness, Disability or Reduced Function

Geographic Coverage

All provinces/territories

Reporting Level/Disaggregation

National, Province/Territory, Region, Neighbourhood Income Quintile

Indicator Results

http://www.cihi.ca/hirpt/?language=en

Identifying Information
NameMental Illness Hospitalization
Short/Other Names

Not applicable

Indicator Description and Calculation
Description

The indicator measures the age-standardized rate of separations from general hospitals through discharge or death following a hospitalization for a selected mental illness,* per 100,000 population.

Note
*The mental illnesses selected for this indicator are substance-related disorders; schizophrenia, delusional and non-organic psychotic disorders; mood/affective disorders; anxiety disorders; and selected disorders of adult personality and behaviour.

For further details, please see the General Methodology Notes.

Calculation: Description

(Total number of separations for a selected mental illness for patients age 15 and older ÷ total mid-year population age 15 and older) × 100,000 (age adjusted)

Unit of Analysis: Single admission

Calculation: Geographic Assignment

Place of residence

Calculation: Type of Measurement

Rate - Per 100,000

Calculation: Adjustment Applied

Age-adjusted

Calculation: Method of Adjustment

Logistic regression

Denominator

Description:
Total mid-year population age 15 and older

Numerator

Description:
Total number of separations for a selected mental illness for patients age 15 and older
Inclusions:
1. A selected mental illness is coded as the most responsible diagnosis (MRDx)

2. Diagnosis codes for selected disorders:

a) Substance-related disorders
ICD-10-CA: F55, F10 to F19
DSM-IV: 291.x (0, 1, 2, 3, 5, 81, 89, 9), 292.0, 292.11, 292.12, 292.81, 292.82, 292.83, 292.84, 292.89, 292.9, 303.xx (00, 90), 304.xx (00, 10, 20, 30, 40, 50, 60, 80, 90), 305.xx (00, 10 to 90 excluding 80)
Provisional diagnosis:* (d) substance-related disorder

b) Schizophrenia, delusional and non-organic psychotic disorders
ICD-10-CA: F20 (excluding F20.4), F22, F23, F24, F25, F28, F29, F53.1
DSM-IV: 295.xx (10, 20, 30, 40, 60, 70, 90), 297.1, 297.3, 298.8, 298.9
Provisional diagnosis:* (e) schizophrenia disorder

c) Mood/affective disorders
ICD-10-CA: F30, F31, F32, F33, F34, F38, F39, F53.0
DSM-IV: 296.0x, 296.2x, 296.3x, 296.4x, 296.5x, 296.6x, 296.7, 296.80, 296.89, 296.90, 300.4, 301.13
Provisional diagnosis:* (f) mood disorders

d) Anxiety disorders
ICD-10-CA: F40, F41, F42, F43, F48.8, F48.9, F93.8
DSM-IV: 300.xx (00, 01, 02, 21, 22, 23, 29), 300.3, 308.3, 309.x (0, 3, 4, 9), 309.24, 309.28, 309.81
Provisional diagnosis:* (g) anxiety disorders or (o) adjustment disorders

e) Selected disorders of adult personality and behaviour
ICD-10-CA: F60, F61, F62, F68, F69, F21
DSM-IV: 300.16, 300.19, 301.0, 301.20, 301.22, 301.4, 301.50, 301.6, 301.7, 301.81, 301.82, 301.83, 301.9
Provisional diagnosis:* (p) personality disorders

Note
*Only for data extracted from the Ontario Mental Health Reporting System (OMHRS) with no DSM-IV code recorded.

3. Age at admission 15 years and older

4. Sex recorded as male or female

5. Canadian resident (Canadian postal code)
Exclusions:
1. Newborn, stillbirth or cadaveric donor records (Admission Category = N, R or S)

2. Records with an invalid health card number

3. Records with an invalid date of birth (non-Quebec records)

4. Records with an invalid admission date

5. Records with an invalid discharge date

Background, Interpretation and Benchmarks
Rationale

Hospitalization rate is a partial measure of general hospital utilization. It does not include inpatients who were using hospital services but had not yet been discharged within the fiscal year of interest. This indicator may reflect differences between jurisdictions, such as the health of the population, differing health service delivery models and variations in the availability and accessibility of specialized, residential and/or ambulatory and community-based services.

Monitoring hospital service use captures only the relatively small proportion of individuals who are acutely ill and require in-hospital treatment, compared with the much larger contingent that receives (or fails to receive) outpatient or community services. For these reasons, this indicator cannot be used to estimate the prevalence of mental disorders in the general population.

Interpretation

Lower rates are desirable.

HSP Framework Dimension

Health System Outputs: Person-centred

Areas of Need

Living With Illness, Disability or Reduced Function

Targets/Benchmarks

Benchmarks have not been identified for this indicator.

The following results were found in the literature. In 2005–2006, the age-standardized rate for general hospitals in Canada was 507.1 separations per 100,000 population.1 Over the last 4 years of reporting, results have been stable.

References

Canadian Institute for Health Information, Hospital Mental Health Services in Canada 2005–2006 (Ottawa, Ont.: CIHI, 2008).

Availability of Data Sources and Results
Data Sources

DAD, HMDB, OMHRS

Available Data Years

Type of Year:
Fiscal
First Available Year:
2009
Last Available Year:
2013

Geographic Coverage

All provinces/territories

Reporting Level/Disaggregation

National, Province/Territory, Region, Neighbourhood Income Quintile

Result Updates
Update Frequency

Every year

Indicator Results

Web Tool:
Health Indicators E-Publication
URL: http://www.cihi.ca/hirpt/?language=en

Updates

Not applicable

Quality Statement
Caveats and Limitations

Individuals can be admitted to hospital more than once for the treatment of a mental illness, and they can have more than 1 condition at a given time. Separation data, therefore, does not represent either the number of mental illnesses that led to the separations or the number of people with mental illness who were separated from the hospital.

Trending Issues

Not applicable

Comments

While this indicator does not include data from free-standing psychiatric facilities, it is acknowledged that in some jurisdictions (e.g., Alberta) direct substitution between general and psychiatric facilities exists; the extent of this practice is unknown. As such, this indicator provides a partial view of hospital utilization for mental health issues in an acute setting.