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Name
Hip Replacement Rate
Short/Other Names

Age-Standardized Rate for Hip Replacements

Description

This indicator measures the age-standardized hospitalization rate for hip replacement procedures performed in acute care facilities per 100,000 population age 18 and older.

Analysis reflects all hip replacement types: total hip replacement, monopolar/bipolar hemiarthroplasty and resurfacing procedures.

For further details, please see the General Methodology Notes.

Interpretation
Does not apply to this measure (that is, there is no predefined preference for the measure score)
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, Region

Indicator Results

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

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<div role="button" class="expandableTitle" aria-controls="identifyingInfoRegion">Identifying Information</div>
Name
Hip Replacement Rate
Short/Other Names

Age-Standardized Rate for Hip Replacements


<div role="button" class="expandableTitle" aria-controls="descAndCalRegion">Indicator Description and Calculation</div>
Description

This indicator measures the age-standardized hospitalization rate for hip replacement procedures performed in acute care facilities per 100,000 population age 18 and older.

Analysis reflects all hip replacement types: total hip replacement, monopolar/bipolar hemiarthroplasty and resurfacing procedures.

For further details, please see the General Methodology Notes.

Calculation: Description
(Total number of hip replacement hospitalizations for persons age 18 and older ÷ Total mid-year population age 18 and older) × 100,000 (age-adjusted)
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 age 18 and older

Numerator

Description:
Total number of discharges for all hip replacement procedures for inpatients age 18 and older

Unit of analysis: Single admission
Inclusions:
1. Hip replacement procedures occurring during inpatient stay

CCI: 1.VA.53^^ and 1.SQ.53^^

Note: Rates are based on the total number of discharges for hip replacement procedures in a given year. Therefore, a patient who received a bilateral hip replacement or underwent multiple hip replacement procedures within a single hospital admission would be counted only once.

2. Age at admission: 18 and older

3. Sex recorded as male or female

4. Admission to an acute care institution (Facility Type Code = 1)
Exclusions:
1. Records with cement spacers not coded as revision (intervention codes 1VA53LASLN and 1VA53LLSLN and Intervention Status Attribute does not equal R)

2. Hip replacement procedures coded as out of hospital or abandoned after onset (OOH Indicator Flag = Y or Intervention Status Attribute = A)

3. Newborn, stillbirth or cadaveric donor records (Admission Category Code = N, R or S)


<div role="button" class="expandableTitle" aria-controls="backgroundRegion">Background, Interpretation and Benchmarks</div>
Rationale

A hip replacement procedure has the potential to improve functional status, reduce pain and contribute to other gains in health-related quality of life. Over the past two decades, rates of hip replacement procedures have increased substantially. Wide inter-regional variation in joint replacement rates may be attributable to numerous factors, including the availability of services, provider practice patterns and patient preferences.

Interpretation

Does not apply to this measure (that is, there is no predefined preference for the measure score)

HSP Framework Dimension

Health System Inputs and Characteristics: Health system resources

Areas of Need

Not applicable

Targets/Benchmarks

Not applicable

References

Not applicable


<div role="button" class="expandableTitle" aria-controls="availabilityRegion">Availability of Data Sources and Results</div>
Data Sources

HMDB

Available Data Years

Type of Year:
Fiscal
First Available Year:
2008
Last Available Year:
2015

Geographic Coverage

All provinces/territories

Reporting Level/Disaggregation

National, Province/Territory, Region


<div role="button" class="expandableTitle" aria-controls="resultRegion">Result Updates</div>
Update Frequency

Every year

Indicator Results

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

Updates

Not applicable


<div role="button" class="expandableTitle" aria-controls="qualityRegion">Quality Statement</div>
Caveats and Limitations

1. Rates are based on the total number of discharges for hip replacement procedures in a given year. However, it is possible for a patient to undergo more than 1 hip replacement procedure in a single discharge.

2. Hip replacement procedures that were not performed in an acute care setting are not included in this indicator.

Trending Issues

As of 2013–2014, the hip replacement rate published in the Health Indicators E-Publication includes partial hip replacement procedures. Comparability with previous years will be affected.

Comments

1. Regional results are available in the Health Indicators E-Publication.

2. Provincial results are also available in the CJRR annual report. Please note the following:

–Prior to 2013–2014, results for Yukon, the Northwest Territories and Nunavut were suppressed in the CJRR annual report (https://secure.cihi.ca/estore/productFamily.htm?locale=en&pf=PFC2625&lang=en&media=0). However, their numbers are included in Canadian calculations.

–Calculation of a patient's geography in the Health Indicators E-Publication is based on the Postal Code Conversion File (PCCF), whereas in the CJRR annual report it is based on the forward sortation area (FSA).

–Beginning with 2015–2016 data, cement spacers are excluded from hip replacement cases when they are not revisions; comparability with previous years should not be affected.

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