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Table Row (tr)
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Name
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Self-Injury Hospitalization
Table Row (tr)
Table Cell (td)
Description
td
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<table class="confluenceTable">


<tr><td>Name</td><td>

Self-Harm Hospitalizations

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</td></tr>

<tr><td>Short/Other Names</td><td>

Not applicable

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</td></tr>


<tr><td>Description</td><td>

Age-standardized rate of hospitalization in a general or psychiatric hospital due to self-

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harm, per 100,000 population

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Table Cell (td)
Interpretation

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For further details, please see the General Methodology Notes (PDF).

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</td></tr>

<tr><td>Interpretation</td><td>

Lower rates are desirable

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as they signal less frequent severe self-harm.

This indicator includes both suicidal and non-suicidal self-harm within the hospitalization data.

The indicator captures only cases within the hospitalization data where intentional self-harm was noted in the medical chart or abstract by a physician. Injuries coded as accidental or undetermined are not included in this indicator, even though

...

Table Row (tr)
Table Cell (td)
HSP Framework Dimension
Table Cell (td)

Health System Outputs: Appropriate and effective

Table Row (tr)
Table Cell (td)
Areas of Need
Table Cell (td)

Living With Illness, Disability or Reduced Function

Table Row (tr)
Table Cell (td)
Geographic Coverage
Table Cell (td)

All provinces/territories

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Table Cell (td)
Reporting Level/Disaggregation

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a portion of these injuries may have been intentional. As such, this indicator underestimates the true number of hospitalizations for self-harm and should be considered a minimum rate of self-harm.

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<tr><td>HSP Framework Dimension</td><td>

Health System Outcomes: Improve health status of Canadians

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</td></tr>

<tr><td>Areas of Need</td><td>

Not applicable

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</td></tr>

<tr><td>Geographic Coverage</td><td>

All provinces/territories

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</td></tr>


<tr><td>Reporting Level/Disaggregation</td><td>

National, Province/Territory, Region, Neighbourhood Income Quintile, Sex

Table Row (tr)
Table Cell (td)
Latest Result Update Date
Table Cell (td)

05/2013

Table Row (tr)
Table Cell (td)
Indicator Results
Table Cell (td)

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

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Identifying Information
Table Row (tr)
Table Cell (td)
Name
Table Cell (td)
Self-Injury Hospitalization
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Table Cell (td)
Short/Other Names
Table Cell (td)

Not Applicable

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Indicator Description and Calculation
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Description
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</td></tr>



<tr><td>Indicator Results</td><td>

Accessing Indicator Results on Your Health System: In Depth (PDF)

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</td></tr>

</table>

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<div id="fullView" role="tabpanel" aria-labelledby="tabFullView">





<div role="button" class="expandableTitle" aria-controls="identifyingInfoRegion">Identifying Information</div>

<table id="identifyingInfoRegion">

<tr><td>Name</td><td>

Self-Harm Hospitalizations

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</td></tr>

<tr><td>Short/Other Names</td><td>

Not applicable

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</td></tr>
</table>



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

<table id="descAndCalRegion">

<tr><td>Description</td><td>

Age-standardized rate of hospitalization in a general or psychiatric hospital due to self-

...

harm, per 100,000 population

...

Table Cell (td)
Calculation: Description

...

For further details, please see the General Methodology Notes (PDF).

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</td></tr>

<tr><td>Calculation: Description</td><td>

(Total number of discharges for

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self-

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harm for patients age

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10 and older ÷ Total mid-year population age

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10 and older) × 100,000 (age-adjusted)

Table Row (tr)
Table Cell (td)
Calculation: Geographic Assignment
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</td></tr>

<tr><td>Calculation: Geographic Assignment</td><td>

Place of residence

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Calculation: Type of Measurement
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</td></tr>

<tr><td>Calculation: Type of Measurement</td><td>

Rate - Rate: per 100,000

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Table Cell (td)
Calculation: Adjustment Applied
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</td></tr>

<tr><td>Calculation:  Adjustment Applied</td><td>

Age-adjusted

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Table Cell (td)
Calculation: Method of Adjustment
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</td></tr>


<tr><td>Calculation:  Method of Adjustment</td><td>

Direct Standardization
Standard Population:
Canada

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2011

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Denominator
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</td></tr>

<tr><td>Denominator</td><td>

Description:
Total mid-year population age

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10 and older

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Numerator
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</td></tr>

<tr><td>Numerator</td><td>

Description:
Total number of

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self-

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harm hospitalizations for patients age

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10 and older
Inclusions:

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  1. Admission to hospital with self-harm diagnosis (diagnosis type 9, ICD-10-CA codes X60 to X84

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2. Patients who were institutionalized in a psychiatric hospital and were self-injured during their stay but did not require admission to a general hospital

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Background, Interpretation and Benchmarks

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Rationale

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  1. ) for those age 10 and older, sex recorded as male or female
  2. Analytical Institution Type Code = 1 (general hospital) or 5 (psychiatric hospital) from the Discharge Abstract Database (DAD)
  3. Wiki Markup
    Ontario Mental Health Reporting System (OMHRS) records for cases where the OMHRS stay was from an initial emergency department (ED) visit for intentional self-harm (X60 to X84 in the National Ambulatory Care Reporting System \[NACRS\]) within 7 days

Additional notes on the inclusions:

  • Episode building was performed to accommodate multiple abstracts within a single episode of care.
  • At this time, we are unable to determine the rate for those not identified as male or female in the data.

Exclusions:

  1. Cadaveric donor or stillbirth records (Admission Category Code = R or S)
  2. Patients with an indication of medical assistance in dying
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    <div role="button" class="expandableTitle" aria-controls="backgroundRegion">Background, Interpretation and Benchmarks</div>
    
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    <tr><td>Rationale</td><td>
    
    Self-harm is defined as a deliberate bodily injury that may or may not result in death. This type of injury is the result of either suicidal or self-harming behaviours, or both. Self-

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  1. harm can be prevented, in many cases, by early recognition, intervention and treatment of mental illnesses. While some risk factors for self-

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  1. harm are beyond the control of the health system, high rates of self-

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  1. harm hospitalizations can be interpreted as the result of a failure of the system to prevent self-

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  1. harms that are severe enough to require hospitalization.

    ...

    Table Cell (td)
    Interpretation

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      <tr><td>Interpretation</td><td>
      
      Lower rates are desirable

    ...

    1. as they signal less frequent severe self-harm.

    This indicator includes both suicidal and non-suicidal self-harm within the hospitalization data.

    The indicator captures only cases within the hospitalization data where intentional self-harm was noted in the medical chart or abstract by a physician. Injuries coded as accidental or undetermined are not included in this indicator, even though

    ...

    Table Row (tr)
    Table Cell (td)
    HSP Framework Dimension
    Table Cell (td)

    Health System Outputs: Appropriate and effective

    Table Row (tr)
    Table Cell (td)
    Areas of Need
    Table Cell (td)

    Living With Illness, Disability or Reduced Function

    Table Row (tr)
    Table Cell (td)
    Targets/Benchmarks
    Table Cell (td)

    Not Applicable

    Table Row (tr)
    Table Cell (td)
    References
    Table Cell (td)

    Canadian Institute for Health Information. National Trauma Registry Analytic Bulletin: Hospitalizations Due to Suicide Attempts and Self-Inflicted Injury in Canada, 2001-2002. Ottawa, ON: CIHI; 2004.

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    Availability of Data Sources and Results
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    Table Cell (td)
    Data Sources
    Table Cell (td)

    DAD, Demography division, Statistics Canada, MED-ÉCHO, NACRS, OMHRS

    ...

    Table Cell (td)
    Available Data Years

    ...

    a portion of these injuries may have been intentional. As such, this indicator underestimates the true number of hospitalizations for self-harm and should be considered a minimum rate of self-harm.

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    </td></tr>
    
    <tr><td>HSP Framework Dimension</td><td>
    

    Health System Outcomes: Improve health status of Canadians

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    </td></tr>
    
    <tr><td>Areas of Need</td><td>
    

    Not applicable

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    </td></tr>
    
    <tr><td>Targets/Benchmarks</td><td>
    

    Not applicable

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    </td></tr>
    
    
    <tr><td>References</td><td>
    

    Not applicable

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

    DAD, HMDB, NACRS, OMHRS

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    </td></tr>
    
    <tr><td>Available Data Years</td><td>
    

    Type of Year:
    Fiscal
    First Available Year:

    ...

    2016
    Last Available Year:

    ...

    2019

    Table Row (tr)
    Table Cell (td)
    Geographic Coverage
    Table Cell (td) HTML
    
    </td></tr>
    
    <tr><td>Geographic Coverage</td><td>
    

    All provinces/territories

    Table Row (tr)
    Table Cell (td)
    Reporting Level/Disaggregation
    td HTML
    
    </td></tr>
    
    
    <tr><td>Reporting Level/Disaggregation</td><td>
    

    National, Province/Territory, Region, Neighbourhood Income Quintile, Sex

    Table Row (tr)
    classsection
    Table Cell (td)
    colspan2
    Result Updates
    Table Row (tr)
    Table Cell (td)
    Update Frequency
    Table Cell (td)

    Every year

    Table Row (tr)
    Table Cell (td)
    Latest Result Update Date
    Table Cell (td)

    05/2013

    Table Row (tr)
    Table Cell (td)
    Indicator Results
    Table Cell (td)

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

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    Table Cell (td)
    Updates
    Table Cell (td)

    Not Applicable

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    Quality Statement
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    Caveats and Limitations
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    </td></tr>
    </table>
    
    
    
    <div role="button" class="expandableTitle" aria-controls="resultRegion">Result Updates</div>
    
    <table id="resultRegion">
    
    <tr><td>Update Frequency</td><td>
    

    Every year

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    </td></tr>
    
    
    
    <tr><td>Indicator Results</td><td>
    

    Web Tool:
    Your Health System: In Depth
    URL:
    Accessing Indicator Results on Your Health System: In Depth (PDF)

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    </td></tr>
    
    <tr><td>Updates</td><td>
    

    Not applicable

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

    This indicator does not include cases of self

    ...

    -harm that are not admitted to hospital. Self-harm where no medical care is sought (including deaths by suicide in the community), or where a patient visits only a primary health care provider or emergency department, will not be captured. Thus this indicator cannot be used to estimate the prevalence of all self-

    ...

    harm in the general population.

    ...

    Table Row (tr)
    Table Cell (td)
    Trending Issues
    Table Cell (td)

    Weyburn Mental Health Centre in Saskatchewan is not included in all mental health–related indicators as requested by the facility. As a result, rates for Sun Country Health Region (4701) in 2009 are not comparable with those reported in subsequent years.

    Brant Community Healthcare System: Brantford General Hospital did not submit its 2009–2010 data to the Ontario Mental Health Reporting System as of the reporting deadline; therefore, it is not included in the indicator calculation. Rates for North East Local Health Integration Network (3513) are not comparable with those reported in subsequent years.

    ...

    Table Cell (td)
    Comments

    ...

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    <tr><td>Trending Issues</td><td>
    

    Beginning in 2020, this indicator replaced the Self-Injury Hospitalization indicator. Results for the 3 fiscal years 2016–2017 to 2018–2019 were calculated, with annual updates planned for future years.

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    <tr><td>Comments</td><td>
    

    Patients in the Discharge Abstract Database–Hospital Morbidity Database (DAD-HMDB) and OMHRS with invalid postal codes will not be included in the numerator of any province but will be included in the all-Canada numerator. An exception to this is patients who are identified as homeless (DAD-HMDB: diagnosis code = Z59.0 or postal code = XX; OMHRS: residential status code = 8); these patients will be assigned to the province of the facility.

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