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Name
Self-Harm Hospitalizations
Short/Other Names

Not applicable

Description

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.

Interpretation

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.

HSP Framework Dimension

Health System Outcomes: Improve health status of Canadians

Areas of Need

Not applicable

Geographic Coverage

All provinces/territories

Reporting Level/Disaggregation

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

Indicator Results

Accessing Indicator Results on Your Health System: In Depth

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

Not applicable


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

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.

Calculation: Description
(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)
Calculation: Geographic Assignment

Place of residence

Calculation: Type of Measurement

Rate - 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 10 and older

Numerator

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:

  • 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


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

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.

Interpretation

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.

HSP Framework Dimension

Health System Outcomes: Improve health status of Canadians

Areas of Need

Not applicable

Targets/Benchmarks

Not applicable

References

Not applicable


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

DAD, HMDB, NACRS, OMHRS

Available Data Years

Type of Year:
Fiscal
First Available Year:
2016
Last Available Year:
2018

Geographic Coverage

All provinces/territories

Reporting Level/Disaggregation

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


<div role="button" class="expandableTitle" aria-controls="resultRegion">Result Updates</div>
Update Frequency

Every year

Indicator Results

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

Updates

Not applicable


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

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.

Trending Issues

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.

Comments

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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