Indicator Metadata

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Detailed View

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 hospitals or same-day surgery facilities per 100,000 population age 18 and older. The indicator includes 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

Identifying Information

Name	Hip Replacement Rate
Short/Other Names	Age-Standardized Rate for Hip Replacements

Indicator Description and Calculation

Description	This indicator measures the age-standardized hospitalization rate for hip replacement procedures performed in acute care hospitals or same-day surgery facilities per 100,000 population age 18 and older. The indicator includes 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 or same-day visits for all hip replacement procedures for patients age 18 and older Unit of analysis: Single admission or same-day visit Inclusions: 1. Hip replacement procedures occurring during inpatient stay or same-day visit CCI: 1.VA.53^^ and 1.SQ.53^^ Note: Rates are based on the total number of discharges or same-day visits 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 or same-day visit 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 or day surgery facility (Facility Type Code = 1 or A) 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)

Background, Interpretation and Benchmarks

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

Availability of Data Sources and Results

Data Sources	DAD, HMDB, NACRS
Available Data Years	Type of Year: Fiscal First Available Year: 2010 Last Available Year: 2018
Geographic Coverage	All provinces/territories
Reporting Level/Disaggregation	National, Province/Territory, Region

Result Updates

Update Frequency	Every year
Indicator Results	Web Tool: Health Indicators e-Publication URL: http://www.cihi.ca/hirpt/?language=en
Updates	Not applicable

Quality Statement

Caveats and Limitations

Rates are based on the total number of discharges or same-day visits for hip replacement procedures in a given year. However, it is possible for a patient to undergo more than one hip replacement procedure in a single hospitalization or day surgery visit.

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.

Beginning with 2016–2017 data, the hip replacement rate published in the Health Indicators e-Publication and CJRR Quick Stats includes hip replacements performed in day surgery settings; comparability with previous years is not affected.

Comments

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

2. Provincial results are also available in Quick Stats. Please note the following:

–Prior to 2013–2014, results for Yukon, the Northwest Territories and Nunavut were suppressed in the CJRR annual report (https://www.cihi.ca/sites/default/files/document/cjrr-annual-report-2018-en.pdf). 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).

–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.

–As of 2016–2017, hip replacements performed in day surgery settings are included in the CJRR annual report.