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about hospital separation data

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  • For each data source, information about data collection and analytical methods, limitations, the citation and additional resources can be found on the Data Sources and Methods page.

A hospital separation is a discharge from a hospital due to death, discharge home, or transfer to another facility. Hospitalization data provide only a crude measure of the condition being quantified for the following reasons: a person may be hospitalized several times for the same disease or injury event, or may be discharged from more than one hospital (when transferred) for the same injury event or may not seek care at a hospital.

SOURCE

Original Source: Canadian Institute for Health Information (CIHI)
Cite as: Hospital In-Patient Discharges Data, 19xx 2013, IntelliHEALTH Ontario, Ministry of Health and Long-Term Care.

METHODS

Data Collection Methods

  • Data are collected based on location of hospital but are generally analyzed by the residence of the patient for health status purposes.
  • The main diagnostic code gives the primary reason for the hospital stay or 'most responsible diagnosis' (MRD).
  • The "most responsible diagnosis" code gives the primary reason for the hospital stay and is coded using the International Statistical Classification of Diseases and Related Health Problems, Canada, Version 10, 2007 (ICD-10-CA) from the Canadian Institute of Health Information started with A through U. A second set of codes for external causes (e-codes) (those starting with V,W,X or Y) are used in the case of an injury to classify the environmental events, circumstances and conditions that caused the injury, for example motor vehicle traffic injury. E-codes are the principal means for classifying injury deaths, but they are not used as a most responsible diagnosis for hospitalizations, so they need to be examined separately. Z-codes are excluded from analysis.

Analysis Methods

  • Prior to March 31 2001, the MRD and e-codes were coded using the Ninth Revision of the International Classification of Diseases (ICD-9). Since April 1, 2001, the MRD and e-codes were coded using the Tenth Revision of the International Classification of Diseases Canada (ICD-10-CA). Comparison of trends for specific causes of hospitalization from 2001 onward with earlier rates must therefore be interpreted with caution.
  • The MRD variable is coded using ICD-10-CA. The ICD-10-CA codes used in these analyses are available electronically.
  • Data in tables are presented as follows:
    • Hospitalization by year
    • Hospitalization by sex and year
    • Hospitalization by age group (and sex if applicable) for most current year and over time if data is available
  • Rates and proportions based on counts less than 5 are suppressed and presented in tables or graphs with the acronym 'NR' not releasable due to small numbers.
  • When calculating directly standardized rates, cell counts of less than 20 are suppressed and presented in tables or graphs with the acronym 'NR' not releasable due to small numbers.
  • Hospitalization visit rates are calculated using two methods:
    • Peel and Peel municipalities compared to Ontario
      • Crude rates are calculated using population estimates as follows:
        • #Hospitalizations/Total population X 100,000
      • Age-standardized rates are calculated using the 1991 Canadian population with population estimates as the denominator, and using the direct method of standardization.
    • Peel data zones compared to Peel and Peel municipalities
      • Crude rates are calculated using the population from individual tax filer data for 2006 to 2011 as the denominator as follows:
        • # Hospitalizations/Total population X 100,000
      • Age-standardized rates are calculated using the 1991 Canadian population and the population from individual tax filer data for 2006 to 2011 as the denominator, and using the direct method of standardization.

LIMITATIONS

  • The number of in-patient hospital discharges reported may differ slightly from other sources due to differences in methodology. The counts presented here represent the number of distinct discharges and not the number of distinct individuals, as an individual may have multiple discharges during the time period examined. In addition, records which have a main problem code of Z00-Z99 (Chapter XXI Factors influencing health status and contact with health services) are not included in any of the tables or graphs presented here.
  • Co-morbidity contributes uncertainty to classifying the most responsible diagnosis.
  • Since a person may not be hospitalized, or may be hospitalized several times for the same disease or injury event, or discharged from more than one hospital (when transferred) for the same injury event, hospitalization data provide only a crude measure of the prevalence of a cause.
  • Data are influenced by factors that are unrelated to health status such as availability and accessibility of care, and administrative policies and procedures. This may influence comparisons between areas and over time.
  • Ontario residents treated outside of the province are excluded. Although less than 0.5% of all procedures performed for Ontario residents are out-of-province, areas bordering other provinces may be more affected.
  • Effective April 1, 2006 hospitalizations for adult patients with mental health codes are now being collected in the Ontario Mental Health Reporting System (OHMRS) when an adult requires a stay in a designated bed in a hospital. This change will result in a reduction of hospitalizations captured in the hospital separation data, under the Mental Health ICD-10, Chapter V Mental and Behavioural Disorders (F00-F99).

REFERENCES AND RESOURCES

  1. APHEO website


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