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  • Measure Summary
  • NQMC:010043
  • May 2015

Mental illness: age-standardized rate of separations from general hospitals through discharge or death following a hospitalization for a selected mental illness per 100,000 population.

Canadian Institute for Health Information (CIHI). Indicator metadata: mental illness hospitalization. [internet]. Ottawa (ON): Canadian Institute for Health Information (CIHI); 2015 [accessed 2015 Nov 19].

View the original measure documentation External Web Site Policy

This is the current release of the measure.

This measure updates a previous version: Canadian Institute for Health Information (CIHI). Health indicators 2013: definitions, data sources and rationale. Ottawa (ON): Canadian Institute for Health Information (CIHI); 2013 May. 89 p.

The measure developer reaffirmed the currency of this measure in April 2016.

Primary Measure Domain

Related Population Health Measures: Population Use of Services

Secondary Measure Domain

Related Population Health Measure: Population Health State

Description

This measure is used to assess the age-standardized rate of separations from general hospitals through discharge or death following a hospitalization for a selected mental illness per 100,000 population age 15 and older.

The mental illnesses selected for this indicator are substance-related disorders; schizophrenia, delusional and non-organic psychotic disorders; mood/affective disorders; anxiety disorders; and selected disorders of adult personality and behaviour.

Calculation Description: (Total number of separations for a selected mental illness for patients age 15 and older ÷ total mid-year population age 15 and older) × 100,000 (age adjusted)

Rationale

Hospitalization rate is a partial measure of general hospital utilization. It does not include inpatients who were using hospital services but had not yet been discharged within the fiscal year of interest. This indicator may reflect differences between jurisdictions, such as the health of the population, differing health service delivery models and variations in the availability and accessibility of specialized, residential and/or ambulatory and community-based services.

Monitoring hospital service use captures only the relatively small proportion of individuals who are acutely ill and require in-hospital treatment, compared with the much larger contingent that receives (or fails to receive) outpatient or community services. For these reasons, this indicator cannot be used to estimate the prevalence of mental disorders in the general population.

Evidence for Rationale

Canadian Institute for Health Information (CIHI). Indicator metadata: mental illness hospitalization. [internet]. Ottawa (ON): Canadian Institute for Health Information (CIHI); 2015 [accessed 2015 Nov 19].

Primary Health Components

Mental illness; substance-related disorders; schizophrenia, delusional and non-organic psychotic disorders; mood/affective disorders; anxiety disorders; personality and behaviour disorders; hospital separations

Denominator Description

Total mid-year population age 15 and older

Numerator Description

Total number of separations for a selected mental illness for patients age 15 and older (see the related "Numerator Inclusions/Exclusions" field)

Type of Evidence Supporting the Criterion of Quality for the Measure

  • A formal consensus procedure, involving experts in relevant clinical, methodological, public health and organizational sciences

Additional Information Supporting Need for the Measure

Unspecified

Extent of Measure Testing

Unspecified

State of Use

Current routine use

Current Use

Monitoring and planning

Monitoring health state(s)

National health policymaking

National reporting

Population health improvement

State/Provincial health policymaking

Measurement Setting

Hospital Inpatient

Professionals Involved in Delivery of Health Services

Physicians

Psychologists/Non-physician Behavioral Health Clinicians

Public Health Professionals

Least Aggregated Level of Services Delivery Addressed

Regional, County or City

Statement of Acceptable Minimum Sample Size

Does not apply to this measure

Target Population Age

Age greater than or equal to 15 years

Target Population Gender

Either male or female

Public Health Aims for Quality

Population-centered

Transparency

IOM Care Need

Not within an IOM Care Need

IOM Domain

Not within an IOM Domain

Case Finding Period

April 1 to March 31

Denominator Sampling Frame

Geographically defined

Denominator (Index) Event or Characteristic

Geographic Location

Patient/Individual (Consumer) Characteristic

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
Total mid-year population age 15 and older

Exclusions
Unspecified

Exclusions/Exceptions

Does not apply to this measure

Numerator Inclusions/Exclusions

Inclusions
Total number of separations for a selected mental illness for patients age 15 and older

  1. A selected mental illness is coded as the most responsible diagnosis (MRDx)
  2. Diagnosis codes for selected disorders:
    1. Substance-related disorders; provisional diagnosis*: (d) substance-related disorder
    2. Schizophrenia, delusional and non-organic psychotic disorders; provisional diagnosis*: (e) schizophrenia disorder
    3. Mood/affective disorders; provisional diagnosis*: (f) mood disorders
    4. Anxiety disorders; provisional diagnosis*: (g) anxiety disorders or (o) adjustment disorders
    5. Selected disorders of adult personality and behaviour; provisional diagnosis*: (p) personality disorders
  3. Age at admission 15 years and older
  4. Sex recorded as male or female
  5. Canadian resident (Canadian postal code)

Note:

  • Individuals can be admitted to hospital more than once for the treatment of a mental illness, and they can have more than one condition at a given time. Separation data, therefore, does not represent either the number of mental illnesses that led to the separations or the number of people with mental illness who were separated from the hospital.
  • Refer to the original measure documentation for the administrative codes.

*Only for data extracted from the Ontario Mental Health Reporting System (OMHRS) with no Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) code recorded.

Exclusions

  • Newborn, stillbirth or cadaveric donor records (Admission Category = N, R or S)
  • Records with an invalid health card number
  • Records with an invalid date of birth (non-Quebec records)
  • Records with an invalid admission date
  • Records with an invalid discharge date

Numerator Search Strategy

Institutionalization

Data Source

Administrative clinical data

Type of Health State

Adverse Health State

Instruments Used and/or Associated with the Measure

Unspecified

Measure Specifies Disaggregation

Does not apply to this measure

Scoring

Rate/Proportion

Interpretation of Score

Does not apply to this measure (i.e., there is no pre-defined preference for the measure score)

Allowance for Patient or Population Factors

Analysis by subgroup (stratification by individual factors, geographic factors, etc.)

Description of Allowance for Patient or Population Factors

  • Indicators are reported at the national, provincial/territorial, and regional levels.
  • Unless otherwise specified, for indicators based on place of residence, data is 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, including out of province, as opposed to the comprehensive activity of the region's hospitals (that will also treat people from outside of the region). Hospitalizations occurring in the U.S. or abroad are not included.
  • For indicators based on place of service (where the patient was treated), data is reported based on the administrative region of the facility (e.g., region of hospitalization).
  • Rates are standardized or risk-adjusted wherever possible to facilitate comparability across provinces/regions/facilities and over time.
  • Standardized rates are adjusted by age (collapsed to five-year groupings) using a direct method of standardization based on the July 1, 1991, Canadian population.

Standard of Comparison

External comparison at a point in, or interval of, time

External comparison of time trends

Internal time comparison

Original Title

Mental illness hospitalization.

Measure Collection Name

Health Indicators ePublication 2015

Submitter

Canadian Institute for Health Information - Nonprofit Organization

Developer

Canadian Institute for Health Information - Nonprofit Organization

Funding Source(s)

Canadian Government

Composition of the Group that Developed the Measure

Employees: Canadian Institute for Health Information (CIHI) Health Indicators

Financial Disclosures/Other Potential Conflicts of Interest

None

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC

2015 May

Measure Maintenance

Annually

Date of Next Anticipated Revision

Unspecified

Measure Status

This is the current release of the measure.

This measure updates a previous version: Canadian Institute for Health Information (CIHI). Health indicators 2013: definitions, data sources and rationale. Ottawa (ON): Canadian Institute for Health Information (CIHI); 2013 May. 89 p.

The measure developer reaffirmed the currency of this measure in April 2016.

Source(s)

Canadian Institute for Health Information (CIHI). Indicator metadata: mental illness hospitalization. [internet]. Ottawa (ON): Canadian Institute for Health Information (CIHI); 2015 [accessed 2015 Nov 19].

Measure Availability

Source available from the Canadian Institute for Health Information (CIHI) Web site External Web Site Policy.

For more information, contact CIHI at 4110 Yonge Street, Suite 300, Toronto, Ontario, Canada, M2P 2B7; Phone: 416-481-2002; Fax: 416-481-2950; E-mail: hsp@cihi.ca; Web site: www.cihi.ca External Web Site Policy.

Companion Documents

The following are available:

  • Canadian Institute for Health Information (CIHI). Indicator library: general methodology notes - clinical indicators, March 2015. Ottawa (ON): Canadian Institute for Health Information (CIHI); 2015 Mar. 19 p. This document is available from the Canadian Institute for Health Information (CIHI) Web site External Web Site Policy.
  • Canadian Institute for Health Information (CIHI). Canadian coding standards for version 2015 ICD-10-CA and CCI. Ottawa (ON): Canadian Institute for Health Information (CIHI); 2015. 511 p. This document is available from the CIHI Web site External Web Site Policy.
  • Canadian Institute for Health Information (CIHI). Health indicators interactive tool. [internet]. Ottawa (ON): Canadian Institute for Health Information (CIHI); [accessed 2015 Jan 20]. This tool is available from the CIHI Web site External Web Site Policy.

NQMC Status

This NQMC summary was completed by ECRI Institute on March 18, 2013. The information was verified by the measure developer on May 17, 2013.

The CIHI informed NQMC that this measure was updated on October 31, 2013 and provided an updated version of the NQMC summary. This NQMC summary was reviewed and updated accordingly by ECRI Institute on February 21, 2014.

This NQMC summary was updated again by ECRI Institute on November 19, 2015. The information was verified by the measure developer on December 3, 2015.

The information was reaffirmed by the measure developer on April 29, 2016.

Copyright Statement

This NQMC summary is based on the original measure, which is subject to the measure developer's copyright restrictions.

Use of Canadian Institute for Health Information's (CIHI) quality measure for research, private study, education, or other non-commercial purposes is permitted where full credit is given to CIHI as author and owner of the quality measure. Any use that is wholly or partly commercial in nature requires CIHI's express written permission.

Questions and inquiries may be directed to: CIHI, Health Indicators, 4110 Yonge Street, Suite 300, Toronto, Ontario, Canada, M2P 2B7; Phone: 416-481-2002; Fax: 416-481-2950.

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