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Name
Assisted Delivery Rate (Overall) Among Vaginal Deliveries
Short/Other Names

Not applicable

Description
Crude assisted delivery rate (overall) among vaginal deliveries
Interpretation
This indicator provides contextual information on obstetrical services across Canada.
HSP Framework Dimension

Health System Inputs and Characteristics: Adjustment to population health needs

Areas of Need

Not applicable

Geographic Coverage

All provinces/territories

Reporting Level/Disaggregation

National, Province/Territory, Region

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=029DB170438205AEBCC75B8673CCE822

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<div role="button" class="expandableTitle" aria-controls="identifyingInfoRegion">Identifying Information</div>
Name
Assisted Delivery Rate (Overall) Among Vaginal Deliveries
Short/Other Names

Not applicable


<div role="button" class="expandableTitle" aria-controls="descAndCalRegion">Indicator Description and Calculation</div>
Description
Crude assisted delivery rate (overall) among vaginal deliveries
Calculation: Description

Rate = (Number of vaginal deliveries assisted by means of forceps extraction, vacuum extraction or a combination of the two) ÷ (Number of vaginal deliveries) × 100

Unit of Analysis: Discharge from acute care facilities

Calculation: Geographic Assignment

Place of residence

Calculation: Type of Measurement

Rate - Rate per 100

Calculation: Adjustment Applied

None

Calculation: Method of Adjustment

Not applicable

Denominator

Description:
Number of vaginal deliveries
Inclusions:
ICD-10-CA delivery codes:

a. Any one diagnosis code of O10 to O16, O21 to O29, O30 to O46, O48, O60 to O75, O85 to O92, O95 or O98 to O99, with a sixth digit of 1 or 2 coded in any position OR

b. Z37 coded in any position
Exclusions:
1. Stillbirth records or newborns

2. Cadaveric donors

3. Non-female records

4. An abortive procedure:

CCI:

a. Any one procedure code of 5.CA.20, 5.CA.24, 5.CA.88, 5.CA.89 or 5.CA.93 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y) OR

b. An ICD-10-CA diagnosis code of O04 coded in any diagnosis field

5. Caesarean section:

CCI Caesarean section delivery codes:

a. A procedure code of 5.MD.60 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y)

Numerator

Description:
Number of vaginal deliveries where a forceps extraction or a vacuum extraction or a combination of the two was applied
Inclusions:
CCI assisted delivery codes:

a. Any one procedure code of 5.MD.53.KL, 5.MD.53.KK, 5.MD.53.KN, 5.MD.53.KM, 5.MD.53.KJ, 5.MD.53.KH, 5.MD.53.KS or 5.MD.53.KP coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y) OR

b. A procedure code of 5.MD.54 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y) OR

c. A procedure code of 5.MD.55 coded in any position that was not abandoned (Status Attribute = A) or done out of hospital (Out-of-Hospital = Y)
Exclusions:
Same as denominator (numerator is a subset of the denominator)


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

Assisted delivery rates among vaginal deliveries continue to vary among provinces and territories. Given this variability, this indicator can be used to inform government planners, policy-makers, health system decision-makers, health care providers, patients and the general public. It can help raise awareness and allow Canada to compare its rates with the rates of other countries.

Interpretation

This indicator provides contextual information on obstetrical services across Canada.

HSP Framework Dimension

Health System Inputs and Characteristics: Adjustment to population health needs

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

DAD, HMDB, MED-ÉCHO

Available Data Years

Type of Year:
Fiscal
First Available Year:
2001
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:
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=029DB170438205AEBCC75B8673CCE822

Updates

As of 2015–2016, the national results include non-residents of Canada.


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

In order to provide a more stable rate estimate, only data from regions with a population of at least 75,000 (from 2001–2002 to 2005–2006) or 50,000 (from 2006–2007 to 2014–2015) was reported. Additional indications for suppression were rate instability and under-reporting. As of 2015–2016, regions are not suppressed based on population; however, numerator and denominator volume thresholds are applied for reporting.

Trending Issues

Data for this indicator was restricted to those provinces and territories that had fully implemented the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Canada (ICD-10-CA) and Canadian Classification of Health Interventions (CCI) coding classification systems. The exception is Quebec, which maintained the ICD-9 and CCP coding classification systems up to 2005–2006. As of 2006–2007, Quebec began to submit in the ICD-10-CA and CCI coding classification systems. As such, Quebec data prior to 2006–2007 may not be comparable with data from 2006–2007 onward. As of 2006–2007, all provinces and territories submit in the ICD-10-CA and CCI coding classification systems; for this reason, Canadian rates are provided only from 2006–2007 onward.

Results are presented for a patient's region of residence rather than the location of the facility where hospitalization occurred. For Prince Edward Island and the territories, the entire province/territory is included as a region. Health regions in Nova Scotia and Alberta have changed over time. The Postal Code Conversion File (PCCF/PCCF+) was used to assign patients to their region of residence.

As of 2015–2016, the national results include non-residents of Canada.

Nunavut did not submit data to CIHI in 2002–2003.

Data from Region 6 in New Brunswick in 2004–2005 was suppressed due to incomplete data submission. Data from this region was excluded from the provincial rate. Data from Peace Country in Alberta in 2006–2007 and 2008–2009 was also suppressed due to incomplete data submission.

Comments

Not applicable

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