Name Mental Health General Hospital Inpatient Separations as a Percentage (Pan-Canadian) of All General Hospital Inpatient Separations, by Province, Diagnosis Category, Sex and/or Age Group
Short/Other Names

Not applicable

Description Percentage of separations (discharges or deaths) for mental illness/addiction out of all general hospital separations by
–Jurisdiction (province/territory)
–Age group
–Sex
–Diagnosis category
Interpretation This indicator provides descriptive information about the proportion of mental illness inpatient separations from general hospitals 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

http://apps.cihi.ca/MicroStrategy/asp/Main.aspx?server=torapprd30.cihi.ca&project=Quick+Stats&uid=pce_pub_en&pwd=&evt=2048001&visualizationMode=0&documentID=D901470C442A5B26D6CC89B28B21C75F

Identifying Information
Name Mental Health General Hospital Inpatient Separations as a Percentage (Pan-Canadian) of All General Hospital Inpatient Separations, by Province, Diagnosis Category, Sex and/or Age Group
Short/Other Names

Not applicable

Indicator Description and Calculation
Description Percentage of separations (discharges or deaths) for mental illness/addiction out of all general hospital separations by
–Jurisdiction (province/territory)
–Age group
–Sex
–Diagnosis category
Calculation: Description Percentage of total separations in general hospitals involving mental illness/addiction = Total separations in general hospitals involving mental illness/addiction divided by total separations in general hospitals involving both mental illness/addiction and non–mental illness/addiction diagnoses, by grouping (such as age, sex, province/territory 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

Not applicable

Denominator

Description:
Inpatient separations from general hospitals involving mental illness/addiction and non–mental illness/addiction diagnoses
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

Exclusions:
1. Newborns

2. Psychiatric hospital separations

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:
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)

For 2011–2012, the following codes were used for inpatient separations involving mental illness/addiction:

–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

For information on prior years, please contact the Mental Health and Addictions team at hmhdb@cihi.ca.

Please refer to About This Quick Stat on the results page for Diagnosis Categories (grouping of diagnosis codes into broad mental health and addiction categories).
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 descriptive information about the proportion of mental illness inpatient separations from general hospitals 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:
2013

Geographic Coverage

All provinces/territories

Reporting Level/Disaggregation

National, Province/Territory

Result Updates
Update Frequency

Every year

Indicator Results

Web Tool:
Quick Stats
URL: http://apps.cihi.ca/MicroStrategy/asp/Main.aspx?server=torapprd30.cihi.ca&project=Quick+Stats&uid=pce_pub_en&pwd=&evt=2048001&visualizationMode=0&documentID=D901470C442A5B26D6CC89B28B21C75F

Updates

For Ontario, for 2006–2007 through 2008–2009, the category Underspecified Disorders was used for diagnosis codes that were insufficiently detailed to allow for categorization into existing mental health categories. Beginning in 2009–2010, records in Underspecified Disorders were categorized in Unknown Disorders.

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.

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 very 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.

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.