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Name
Hysterectomy Rate
Short/Other Names

Not applicable

Description

This indicator measures the age-standardized rate of hysterectomy provided to patients in acute care hospitals or same-day surgery facilities, per 100,000 women age 18 and older.

For further details, please see the General Methodology Notes.

Interpretation
Does not apply to this measure (i.e., 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 id="fullView" role="tabpanel" aria-labelledby="tabFullView">

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

Not applicable


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

This indicator measures the age-standardized rate of hysterectomy provided to patients in acute care hospitals or same-day surgery facilities, per 100,000 women age 18 and older.

For further details, please see the General Methodology Notes.

Calculation: Description

(Total number of discharges for hysterectomy for women age 18 and older ÷ total mid-year female population age 18 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

Direct Standardization
Standard Population:
Canada 2011

Denominator

Description:
Total mid-year female population age 18 and older

Numerator

Description:
Total number of discharges for hysterectomy for women age 18 and older

Inclusions:
1. Hysterectomy is identified as any of the following procedure codes recorded in any position of the procedure code fields:

CCP: 80.2–80.6

CCI: 1.RM.89^, 1.RM.91^ or any of the following codes: 1.RM.87.CA-GX, 1.RM.87.DA-GX, 1.RM.87.LA-GX with extent attribute coded as SU

2. Age at admission 18 years and older

3. Sex recorded as female

4. Admission to an acute care institution or same-day surgery facility (Facility Type Code = 1 or A)

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

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


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

As with other types of surgical procedures, variation in hysterectomy rates can be attributed to numerous factors, including differences in population demographics, physician practice patterns and availability of services. Utilization rates may reflect the level of uncertainty about the appropriate use of this surgical procedure. The right level of utilization is not known.

Interpretation

Does not apply to this measure (i.e., 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

Benchmarks have not been established for this procedure.

References

Cohen, M. M. and W. Young. "Hysterectomy." In Patterns of Health Care in Ontario, 2nd Ed. Eds. V. Goel et al. Ottawa, Ont.: Canadian Medical Association, 1996: p. 141.

Cumming, D. C. "Hysterectomy Revisited." Journal of Obstetrics and Gynecology Canada 18 (1996): pp. 869-879.

Gimbel, H. "Total and Subtotal Hysterectomy for Benign Uterine Diseases? A Meta-Analysis." Acta Obstetricia et Gynecologica 86 (2007): pp. 133-144.

Lefebvre, G. et al. "SOGC Clinical Practice Guidelines - Hysterectomy." Journal of Obstetrics and Gynecology Canada 109 (2002).

Zekam, N. et al. "Total Versus Subtotal Hysterectomy: A Survey of Gynecologists." Obstetrics and Gynecology 102 (2003): pp. 301-305.


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

DAD, HMDB, NACRS

Available Data Years

Type of Year:
Fiscal
First Available Year:
1997
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

Subtotal hysterectomy was not uniquely identified in the Canadian Classification of Health Interventions (CCI) versions 2001 and 2003; therefore, hysterectomy rates reported for 2001–2002 to 2005–2006 included only total hysterectomies.

Trending Issues

Beginning with the 2006–2007 rate, hysterectomy cases include both total and subtotal hysterectomies, similar to reporting prior to 2001–2002 data. Subtotal hysterectomy was not uniquely identified in CCI versions 2001 and 2003; therefore, hysterectomy rates reported for 2001–2002 to 2005–2006 included only total hysterectomies. Identification of subtotal hysterectomies became possible again with version 2006 of CCI. For jurisdictions with higher volumes of subtotal hysterectomies, comparability with previous years might be affected.

Beginning with the 2005–2006 rate, this indicator includes same-day surgery procedures. However, due to small volumes of hysterectomy in same-day surgery settings, comparability with previous years should not be affected.

This data was not produced for fiscal year 2012–2013.

Comments

Not applicable

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