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<table class="confluenceTable">


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

Self-Harm Hospitalizations

</td></tr>

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

Not applicable

</td></tr>


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

Age-standardized rate of hospitalization in a general or psychiatric hospital due to self-harm, per 100,000 population

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

</td></tr>

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

Lower rates are desirable 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 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.

</td></tr>

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

Health System Outcomes: Improve health status of Canadians

</td></tr>

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

Not applicable

</td></tr>

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

All provinces/territories

</td></tr>


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

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

</td></tr>



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

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

</td></tr>

</table>

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

<table id="identifyingInfoRegion">

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

Self-Harm Hospitalizations

</td></tr>

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

Not applicable

</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

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

</td></tr>

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

(Total number of discharges for self-harm for patients age 10 and older ÷ Total mid-year population age 10 and older) × 100,000 (age-adjusted)

</td></tr>

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

Place of residence

</td></tr>

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

Rate - Rate: per 100,000

</td></tr>

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

Age-adjusted

</td></tr>


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

Direct Standardization
Standard Population:
Canada 2011

</td></tr>

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

Description:
Total mid-year population age 10 and older

</td></tr>

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

Description:
Total number of self-harm hospitalizations for patients age 10 and older
Inclusions:

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

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>
    
    <table id="backgroundRegion">
    
    <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-harm can be prevented, in many cases, by early recognition, intervention and treatment of mental illnesses. While some risk factors for self-harm are beyond the control of the health system, high rates of self-harm hospitalizations can be interpreted as the result of a failure of the system to prevent self-harms that are severe enough to require hospitalization.
    </td></tr>
    
    
    <tr><td>Interpretation</td><td>
    
    Lower rates are desirable 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 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.

</td></tr>

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

Health System Outcomes: Improve health status of Canadians

</td></tr>

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

Not applicable

</td></tr>

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

Not applicable

</td></tr>


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

Not applicable

</td></tr>
</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

</td></tr>

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

Type of Year:
Fiscal
First Available Year:
2016
Last Available Year:
2019

</td></tr>

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

All provinces/territories

</td></tr>


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

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

</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

</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)

</td></tr>

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

Not applicable

</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.

</td></tr>


<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.

</td></tr>


<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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