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 Name
 30-Day Stroke In-Hospital Mortality
 Short/Other Names
 Not applicable
 Description
 The risk-adjusted rate of all-cause in-hospital death occurring within 30 days of first discharge from an acute care hospital with a diagnosis of stroke For further details, please see the General Methodology Notes.
 Interpretation
 Lower rates are desirable.
 HSP Framework Dimension
 Health System Outputs: Appropriate and effective
 Areas of Need
 Getting Better
 Geographic Coverage
 All provinces/territories
 Reporting Level/Disaggregation
 National, Province/Territory, Region
 Indicator Results
 http://yourhealthsystem.cihi.ca/epub/?language=en
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Identifying Information
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 Name
 30-Day Stroke In-Hospital Mortality
 Short/Other Names
 Not applicable
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Indicator Description and Calculation
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 Description
 The risk-adjusted rate of all-cause in-hospital death occurring within 30 days of first discharge from an acute care hospital with a diagnosis of stroke For further details, please see the General Methodology Notes.
 Calculation: Description
 The risk-adjusted mortality rate (RAMR) is calculated by dividing the observed number of in-hospital deaths by the expected number of in-hospital deaths and multiplying by the Canadian average in-hospital death rate. Unit of Analysis for Denominator Cases: Single admission
 Calculation: Geographic Assignment
 Place of residence or service
 Calculation: Type of Measurement
 Rate - per 100
 The following covariates are used in risk adjustment: For a detailed list of covariates used in the model, please refer to the Model Specification document.
 Logistic regression
 Denominator
 Numerator
 Description: Number of deaths from all causes occurring in hospital within 30 days of admission for stroke Inclusions: 1. Discharge as death (Discharge Disposition Code = 07) 2. Admission to an acute care institution (Facility Type Code = 1) 3. (Discharge date on death record) − (Admission date on stroke record) less than or equal to 30 days Exclusions: 1. Records with an invalid discharge date
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Background, Interpretation and Benchmarks
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 Rationale
 Stroke is a leading cause of death and long-term disability. Adjusted mortality rates following stroke may reflect the underlying effectiveness of treatment and quality of care. Furthermore, variations in stroke mortality rates may be due to jurisdictional and institutional differences in care practices, as well as to other factors that are not included in the adjustment.
 Interpretation
 Lower rates are desirable.
 HSP Framework Dimension
 Health System Outputs: Appropriate and effective
 Areas of Need
 Getting Better
 Targets/Benchmarks
 Not applicable
 References
 Hosmer DW, Lemeshow S. Confidence Interval Estimates of an Index of Quality Performance Based on Logistic Regression Models. Stat Med 1995(14): 2161-2172. Mayo NE, Goldberg MS, Levy AR, et al. Changing Rates of Stroke in the Province of Quebec, Canada: 1981-1988. Stroke 1991;22(5): 590-595. Mayo NE, Neville D, Kirkland S, et al. Hospitalization and Case-Fatality Rates for Stroke in Canada From 1982 Through 1991. The Canadian Collaborative Study Group of Stroke Hospitalizations. Stroke 1996(27): 1215-1220. Weir N, Dennis MS. Towards a National System for Monitoring the Quality of Hospital-Based Stroke Services. Stroke 2001(32): 1415-1421.
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Availability of Data Sources and Results
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 Data Sources
 Available Data Years
 Type of Year: Fiscal First Available Year: 1998 Last Available Year: 2015
 Geographic Coverage
 All provinces/territories
 Reporting Level/Disaggregation
 National, Province/Territory, Region
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 Update Frequency
 Every year
 Indicator Results
 Web Tool: Health Indicators E-publication URL: http://yourhealthsystem.cihi.ca/epub/?language=en
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