8. Health System Indicators (Canadian Institute for Health Information – CIHI)

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CIHI’s Privacy and Confidentiality policy does not permit the publication of data that might reasonably identify an individual, whether a patient or care provider, without consent. As a result, measures were taken to protect against residual disclosure from the dissemination of the regional rates including the suppression of cells containing small numbers. In addition, reporting data based on the region of the patient’s residence (not hospitalization) reduces opportunities for identifying individual care providers.

Hospitalization data and rates (CIHI)

  • Unless otherwise specified, data are reported based on the region of the patient’s residence, not region of hospitalization. Consequently, these figures reflect the hospitalization experience of residents of the region wherever they are treated, as opposed to the comprehensive activity of the region’s hospitals (who will also treat people from outside of the region).
  • In–hospital hip fracture rate is reported by the jurisdiction where hospitalization has occurred rather than by the jurisdiction of patient residence.
  • Health region level data for the provinces and territories were produced using the postal code conversion file (PCCF). Records with invalid, missing, or partial postal codes are not included in the regional rates; however records with partial postal codes are included in the provincial rates. The boundaries are those that were in effect as of December 2014.

  • The absence of complete postal codes from Quebec may affect rates for the border regions in other provinces.
  • At the Canada level and provincial levels, rates for health data that are based on a fiscal year (April to March) use October 1st population estimates. Unless otherwise specified, Canadian and provincial hospitalization rates are standardized using the same methodology as regional rates. Other rates are based on appropriate population figures. Standardized rates are age-adjusted using a direct method of standardization based on the July 1st, 1991 Canadian population. See section 2.2.2 for details.
  • Unless otherwise specified, hospitalizations include discharges and deaths for inpatients in acute care hospitals for the reference period. Same day surgery (outpatient) cases are included in several indicators (see www.cihi.ca/indicators for exceptions).  Patients admitted to non-acute care hospitals (for example chronic care, chronic care, psychiatric or rehabilitation facilities) are generally not included in the totals.
  • Indicators based on the Discharge Abstract Database include only jurisdictions that submit comprehensively to the database. Therefore, these indicators for Quebec are not available and the rate Canada rate does not include Quebec.
  • Cancelled, previous, and “abandoned after onset” procedures are excluded from the calculations, wherever this information is available.

Neighbourhood Income Quintiles

  • Neighbourhood income quintiles were based on the average income per single-person equivalent in a dissemination area (DA) obtained from the 2011 census. This measure uses the person weights implicit in the Statistics Canada low-income cut-offs to derive "single-person equivalent" multipliers for each household size.
  • To calculate average income per single-person equivalent for each DA, total income of the dissemination area was divided by the total number of single-person equivalents. Next, quintiles of population by neighbourhood income were constructed separately for each census metropolitan area, census agglomeration or residual area within each province. DAs within each such area were ranked from the lowest average income per single-person equivalent to the highest, and DAs were assigned to five groups, such that each group contained approximately one-fifth of the total non-institutional population of each area. The quintile data was then pooled across the areas.
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