Query Reference MH1 HMHDB Hospital Mental Health Services in Canada

Transcription

1 Query Reference MH1 HMHDB Hospital Mental Health Services in Canada Interactive tables Pan-Canada Pan-Canadian Interactive Tables for Mental Illness or Addiction With Breakdowns by Diagnosis Grouping and Hospital Type (General Versus Psychiatric) Crude Separation Rate (per 100,000) Age-Standardized Separation Rate (per 100,000) Average Length of Stay Median Length of Stay Province/territory Provincial/Territorial Interactive Tables for Mental Illness or Addiction With Breakdowns by Diagnosis Grouping and Hospital Type (General Versus Psychiatric) Crude Separation Rate (per 100,000) Age-Standardized Separation Rate (per 100,000) Average Length of Stay Median Length of Stay

2 Age group/sex Provincial/Territorial Interactive Tables for Mental Illness or Addiction With Breakdowns by Age Group and/or Sex Data sources Population Estimates, Statistics Canada Hospital Mental Health Database (HMHDB), Canadian Institute for Health Information The HMHDB is a pan-canadian database containing information on separations (discharges and deaths) involving mental illness or addiction from Canadian psychiatric and general hospitals. This information comes from the following CIHI data sources: Discharge Abstract Database (DAD)/Hospital Morbidity Database (HMDB); Ontario Mental Health Reporting System (OMHRS); and Hospital Mental Health Survey (HMHS). Important notes Additional information about the HMHDB is available in the Hospital Mental Health Database: User Documentation. As of , the following codes are used for inpatient separations (discharges and deaths) involving mental illness or addiction: DSM-IV-TR: , , , 625.0, and ; ICD-9-CM: and ; and ICD-10-CA: F00 F99, G30, R41.0, R41.3 and O For information on prior years, please contact the Mental Health and Addictions team at mentalhealth@cihi.ca. Fiscal years (April 1 to March 31) are used. Separations by year are based on the date of discharge, not the date of admission. Newborns, stillbirths and cadaveric donors are excluded from the HMHDB. The HMHDB is an event-based rather than a person-based database; individuals may be represented multiple times in the data. may include days stayed that occurred prior to the fiscal year of separation. Only cases with a primary diagnosis of mental illness or addiction on separation are included in the analyses. 2

3 Separations were assigned to Diagnosis Groups based on the primary diagnosis or the diagnosis that contributed most to the patient s length of stay during that hospitalization period. Percentage of All Separations = Total separations in general hospitals for a primary diagnosis of mental illness or addiction Total separations in general hospitals for all primary diagnoses. Percentages are available by province and age, sex or diagnosis group. Percentage of Total Days Stayed = Total days stayed in general hospitals for a primary diagnosis of mental illness or addiction Total days stayed in general hospitals for all primary diagnoses. Percentages are available by province and age, sex or diagnosis group. In and , data from Quebec s psychiatric hospitals was not included due to a data quality issue identified by the province. The total for psychiatric hospitals did not include Quebec data. Quebec data for general hospitals was included. For through , data from 4 psychiatric hospitals in Ontario was excluded due to data quality issues. For and , the proportion of separations (discharges or deaths) in the database affected by this data quality issue dropped to less than 0.2%, and it further dropped to less than 0.01% in and onward; these separations were excluded from Quick Stats analyses. For Ontario, for through , the category Underspecified Disorders was used for diagnosis codes that were insufficiently detailed to allow for categorization into existing mental health categories. Beginning in , records in this category (Underspecified Disorders) were categorized in Unknown Disorders. Crude and age-standardized rate calculations For , , , , , and , crude rate calculations at the provincial/territorial and regional levels are based on population estimates from Statistics Canada as of July 1, 2006, 2007, 2008, 2009, 2011, 2012 and 2013, respectively. For , crude rate calculations at the provincial/territorial and regional levels are based on population estimates from Statistics Canada as of October 1, Standardized rates are age-adjusted using a direct method of standardization based on the July 1, 1991, Canadian population. Interpretation of data The basic unit of observation is the discharge abstract or the record of an inpatient s stay in a psychiatric i or general ii hospital. The discharge abstract is completed at separation (discharge or death). Records are grouped into fiscal years based on the inpatient s date of separation from the hospital. If an individual was hospitalized more than once in the same fiscal year, a separate record for each stay was submitted. Hence the basic units of observation are events, not unique patients. If an inpatient was admitted prior to the beginning of a fiscal year, the days stayed prior to the year of separation are included in the total days stayed for that event. i. In Canada, there is no standard definition of a psychiatric hospital. For the purposes of this report, psychiatric hospitals are medical hospitals that provide psychiatric services on an inpatient and/or outpatient basis and that have been identified by the provinces or CIHI. ii. For the purposes of this report, a general hospital is a publicly funded hospital that provides primarily for the diagnosis and treatment of inpatients and clients with a wide range of diseases or injuries. The services of a general hospital are not restricted to a specific age group or sex. Within the HMHDB frame, facility types such as non-teaching general hospitals with or without long-term care units, pediatric hospitals, teaching general hospitals and specialty institutions (cancer, cardiology, maternity, extended and chronic care, rehabilitation, neurological, orthopedic, etc.) are included. Contact CIHI for more information about the facilities included in the HMHDB frame. 3

4 Factors that affect indicator results Many factors contribute to the observed variations in the analysis of indicators at the provincial/territorial and regional levels. These include, but are not limited to, geography, population health, provincial and regional health service resources, and environmental and socio-economic characteristics. It is important to consider these factors and the effect they may have on indicator results when conducting comparative analyses. Contact details For more information about the Hospital Mental Health Database, please send an to For assistance using interactive CIHI data, please send an to All other inquiries can be directed to Canadian Institute for Health Information 495 Richmond Road, Suite 600 Ottawa, Ontario K2A 4H6 Phone: Fax: Last updated: October 6,

5 diagnostic groupings Diagnosis Category Subcategory DSM-IV Code ICD-9-CM Code ICD-10-CA Code Senile and pre-senile psychotic conditions , , , 290.3, , Organic Disorders Transient organic psychotic conditions 293.0, , 293.1, , , F00 F09, F53.1, G30, R41.3 Other organic psychotic conditions 294.0, 294.8, , , 294.9, 310.1, , 294.1, 294.8, Alcoholic psychoses , , , Drug psychoses 292.0, , , , , , , , , 292.2, , , Substance-Related Disorders Alcohol dependence , , Drug dependence , , , , , , , , , , , , , , , , , , F10 F19, F55 Nondependent abuse of drugs , , , , , , , , 305.1, , , , , , , , Schizophrenic and Psychotic Disorders Schizophrenia , , , , , , Psychoses 298.8, , , , , , , , , , , F20 F29, R41.0 Paranoia, delusional disorders, other psychoses 297.1, 297.3, , , 297.8, 297.9, Bipolar , , , , 296.7, , , , , , , , 296.7, , F30 F31 Mood Disorders Depression , , 300.4, , , 300.4, 311 F32 F33, F34.1, F53.0 Other , , F34.0, F34.8, F34.9, F38, F39 Anxiety , , , 300.3, , , , , 300.3, F40 F42, F93.0 F93.2 Anxiety Disorders Acute stress , , 308.3, , F43.0, F43.1, F43.8, F43.9 Personality Disorders Personality disorders 301.0, , , 301.4, , 301.6, 301.7, , , , , 301.3, 301.4, , , 301.6, 301.7, , , F60 F62, F68 F69 Adjustment disorders 309.0, , , 309.3, 309.4, , , , , , , F43.2, F99 Physiological malfunction arising from mental factors , , , , F59 Sexual disorders , , , , , 302.9, , , , 625.0, , , 302.6, , , , , F52, F64, F65, F66 Dissociative and factitious disorders , , , , F44, F48.1 Somatoform disorders , 300.7, , , , , 300.9, , F45 Eating disorders 307.1, , , , F50 Other Disorders Disorders of infancy, childhood, adolescence, and developmental disorders , , , 302.6, 307.0, , 307.3, , , , 307.6, 307.7, 307.9, , , , , 312.9, , , , , 313.9, , , 314.9, , 315.1, 315.2, , , , 315.4, 315.9, 317, , , , , , , 307.0, 307.3, 307.6, 307.7, 307.9, , , , , 312.4, , , , 312.9, 313.0, 313.1, , 313.3, , , 313.9, , , , , , 315.1, 315.2, , , 315.4, 315.5, 315.8, 315.9, 317, , 319 F70 F73, F78 F79, F80 F89, F90, F91 F92, F93.0, F93.3, F93.8 F93.9, F94, F95, F98 Sleep disorders , F51 Impulse control disorders , , F63 Mental disorders due to a general medical condition not elsewhere classified , , , 310.8, 310.9, 316 F54 All other psychiatric disorders , F48.0, F48.8, F48.9, F53.8, F53.9, O99.3 Notes The following codes may be found in more than 1 category in the above grouping table: DSM-IV-TR , , , , ; ICD-9-CM , , , , , ; ICD-10-CA F93.0. To avoid double counting separations, these codes have been grouped to only 1 broad diagnosis category within the HMHDB. The volume of separations for these codes is very low (ranging from 0 to 35 nationally for the data year), and consequently the impact on categorization to one category versus another is minimal. Diagnostic groupings correspond to data. For information on diagnostic groupings for prior years, please contact the Mental Health and Addictions team at mentalhealth@cihi.ca. 5