The data

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The data are from the Canadian Institute of Health Information's Discharge Abstract Database and are compiled from discharge records for inpatients in acute care hospitals.16 This analysis excludes newborns, stillbirths, Quebec residents, patients not resident in Canada, and those without a usable patient identification number. Records with missing admission or separation dates and those missing gender were also excluded. A total of 2,069,690 records for patients who were separated from hospital during fiscal year 2009/2010 (April through March) were retained for this study.

A hospital record is generated for each hospital separation when the patient leaves the facility because of discharge, transfer, sign-out against medical advice, or death. The hospital records in this analysis pertain to inpatient care; they do not include out-patient visits.

A "most responsible" diagnosis is assigned to each hospital record. Reported diagnoses of mental conditions that were not designated "most responsible" were considered to be "comorbid."  To identify mental diagnoses, the International Classification of Diseases tenth revision (ICD-10-CA) codes were used.1,17-19

Length of stay is the number of days indicated in a hospital record; specifically, the number of days from the date of admission to the date of discharge. If admission and discharge occurred the same day, the length of stay was set to 0.5. Only days within fiscal year 2009/2010 were included (April 1, 2009 to March 31, 2010).

Descriptive statistics (percentages and averages) were calculated using SAS version 9.1.3.