Indicator Metadata

Epidural Rate for Vaginal Deliveries

Not applicable

Crude epidural rate for vaginal deliveries

Rate = (Number of vaginal deliveries where an epidural anesthetic was used) ÷ (Number of vaginal deliveries) × 100

Unit of Analysis: Discharges from acute care facilities

Place of residence

Rate - Per 100

None

Not applicable

Description:
Number of vaginal deliveries

Inclusions:

1. Delivery codes included in the denominator are as follows:
   ICD-10-CA delivery codes:
   1. 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
   2. Z37 coded in any position

Exclusions:

1. Stillbirth records or newborns
2. Cadaveric donors
3. Non-female records
4. An abortive procedure:
   CCI:
   1. 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
   2. An ICD-10-CA diagnosis code of O04 coded in any diagnosis field
5. Caesarean section:
   CCI Caesarean section delivery codes:
   1. 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)

Description:
Number of vaginal deliveries where an epidural anesthetic was used
Inclusions:

CCI epidural codes:

1. Anesthetic Technique Code = 3 (Epidural) OR
2. A procedure code of 5.LD.20.HA-P1 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)

Epidural rates for all deliveries continue to vary among provinces/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.

This indicator provides contextual information on obstetrical services across Canada.

Health System Inputs and Characteristics: Adjustment to population health needs

Not applicable

Not applicable

Not applicable

DAD, HMDB, MED-ÉCHO

Type of Year:
Fiscal
First Available Year:
2001
Last Available Year:
2018

All provinces/territories

National, Province/Territory, Region

Every year

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

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

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; instead, the following suppression methodology is used:

1. Suppression due to privacy: To ensure privacy, a suppression rule is applied to all clinical indicator results. Numerators and/or denominators between 1 and 4 are suppressed.
2. Suppression due to unstable results: Unstable indicator results are suppressed. In general, these are indicator results with a denominator between 1 and 49.

Data for this indicator was restricted to those provinces and territories that had fully implemented the ICD-10-CA and CCI coding classification system. The exception is Quebec, which maintained the ICD-9 and CCP coding classification system up to 2005–2006. As of 2006–2007, Quebec began to submit in the ICD-10-CA and CCI coding classification system. 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 were submitting in the ICD-10-CA and CCI coding classification system; 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 P.E.I. 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.

Data from 2005–2006 in Alberta and data from 2006–2007 in Newfoundland and Labrador was suppressed due to under-reporting of epidural use. Data from Chinook region in Alberta between 2001–2002 and 2005–2006 was also suppressed for this reason.

2016–2017 data for Nunavut is incomplete; indicator results have therefore been suppressed.

Not applicable