Health Indicators 2012

Health Indicators 2012
Health Indicators 2012
Our Vision
Better data. Better decisions.
Healthier Canadians.
Our Mandate
To lead the development and
maintenance of comprehensive
and integrated health information
that enables sound policy and
effective health system management
that improve health and health care.
Our Values
Respect, Integrity, Collaboration,
Excellence, Innovation
Table of Contents
About the Canadian Institute for Health Information . . . . . . . . . . . . . . . . . . . . . . . . . . . iii
About Statistics Canada . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v
Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
Health Indicator Framework . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii
In Focus: Avoidable Mortality in Canada . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Premature Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Potentially Avoidable Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Mortality From Preventable and Treatable Causes . . . . . . . . . . . . . . . . . . . . . . . 17
How Does Canada Compare Internationally? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Implications for Health and Social Policy and the Provision of Care . . . . . . . . . . . 31
Appendix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Health Indicators: Region by Region . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Health Region Profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Health Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Equity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Non-Medical Determinants of Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Health System Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Community and Health System Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . 84
General Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Indicator Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Regional Maps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
About the Canadian Institute for Health Information
About the Canadian Institute
for Health Information
The Canadian Institute for Health Information (CIHI) collects and analyzes information
on health and health care in Canada and makes it publicly available. Canada’s federal,
provincial and territorial governments created CIHI as a not-for-profit, independent
organization dedicated to forging a common approach to Canadian health information.
CIHI’s goal: to provide timely, accurate and comparable information. CIHI’s data and
reports inform health policies, support the effective delivery of health services and
raise awareness among Canadians of the factors that contribute to good health.
For more information, visit our website at www.cihi.ca.
As of March 15, 2012, the following individuals are members of CIHI’s Board of Directors:
Dr. Brian Postl
Chair of the Board, CIHI
Dean of Medicine
University of Manitoba
Mr. John Wright (ex officio)
President and Chief Executive Officer
CIHI
Dr. Luc Boileau
President and Director General
Institut national de santé publique du Québec
Dr. Marshall Dahl
Consultant Endocrinologist
Vancouver Hospital and Health Sciences Centre and Burnaby Hospital
Ms. Janet Davidson
Canadian Head of the Global Healthcare Center of Excellence
KPMG
Dr. Chris Eagle
President and Chief Executive Officer
Alberta Health Services
Mr. Donald Ferguson
Deputy Minister
Department of Health, New Brunswick
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Health Indicators 2012
Dr. Vivek Goel
President and Chief Executive Officer
Public Health Ontario
Mr. Denis Lalumière
Assistant Deputy Minister, Planning, Performance and Quality
Ministère de la Santé et des Services sociaux du Québec
Mr. John McGarry
Private Health Administration Consultant
Dr. Cordell Neudorf
Chair, CPHI Council
Chief Medical Health Officer, Saskatoon Health Region
Mr. Saäd Rafi
Deputy Minister
Ministry of Health and Long-Term Care, Ontario
Dr. Marlene Smadu
Associate Dean of Nursing
University of Saskatchewan
Mr. Wayne Smith
Chief Statistician
Statistics Canada
Mr. Howard Waldner
President and Chief Executive Officer
Vancouver Island Health Authority
Mr. Graham Whitmarsh
Deputy Minister
Ministry of Health Services, British Columbia
iv
About Statistics Canada
About Statistics Canada
Statistics Canada produces statistics that help Canadians better understand their
country—its population, resources, economy, society and culture.
The Health Statistics Division provides information about the health of the Canadian
population, the determinants of health and the utilization of Canada’s health
care resources. The information is used to assist and support health planners
and decision-makers at all levels of government to sustain demographic and
epidemiological research and to report to the Canadian public about their collective
health and health care system.
How to Obtain More Information
For information about this product or the wide range of services and data available
from Statistics Canada, visit our website at www.statcan.gc.ca, email us at
[email protected] or telephone us, Monday to Friday from 8:30 a.m. to
4:30 p.m., at the following numbers:
Statistics Canada’s National Contact Centre
Toll-free telephone (Canada and United States):
Inquiries line: 1-800-263-1136
National telecommunications device for the hearing impaired: 1-800-363-7629
Fax line: 1-877-287-4369
Local or international calls:
Inquiries line: 1-613-951-8116
Fax line: 1-613-951-0581
Depository Services Program
Inquiries line: 1-800-635-7943
Fax line: 1-800-565-7757
Standards of Service to the Public
Statistics Canada is committed to serving its clients in a prompt, reliable and courteous
manner. To this end, Statistics Canada has developed standards of service that its
employees observe. To obtain a copy of these service standards, please contact
Statistics Canada toll-free at 1-800-263-1136. The service standards are also published
on www.statcan.gc.ca under About us > The agency > Providing services to Canadians.
v
Acknowledgements
Acknowledgements
The Canadian Institute for Health Information (CIHI) would like to acknowledge and
thank the many individuals and organizations that contributed to the development of
this report.
In particular, the Health Indicators 2012 report benefited greatly from consultations
with our stakeholders across the country. The assistance offered by many individuals
in health regions, provinces and territories who reviewed these indicators and offered
useful suggestions is gratefully acknowledged.
We would like to acknowledge and express our appreciation to the Expert Advisory
Group for its invaluable advice:
Dr. Cordell Neudorf, Chief Medical Health Officer, Saskatoon Health Region
Dr. Kimberlyn McGrail, Associate Director and Assistant Professor, Centre for Health
Services and Policy Research and School of Population and Public Health, University
of British Columbia
Ms. Jean Harvey, Director, Canadian Population Health Initiative, Canadian Institute
for Health Information
Dr. Martin McKee, CBE, Professor, European Centre on Health of Societies in
Transition, London School of Hygiene and Tropical Medicine, United Kingdom
Dr. Martin Tobias, Health and Disability Intelligence, New Zealand Ministry of Health
For advice on the development of the avoidable mortality indicators, we would like to
extend our great appreciation to Dr. Gregory P. Marchildon, Dr. Douglas Manuel,
Dr. Stafford Dean, Dr. Michael Wolfson and Ms. Ruth Lavergne (PhD candidate,
University of British Columbia).
It should be noted that the analyses and conclusions in this report do not necessarily
reflect the opinions of the experts or their affiliated organizations.
The following people provided guidance and leadership throughout the development
and production of this report:
Jeremy Veillard, Vice President, CIHI
Kira Leeb, Director, CIHI
Joanne Hader, Manager, CIHI
Yana Gurevich, Methodologist, CIHI
Zeerak Chaudhary, Project Lead, CIHI
Brenda Wannell, Chief, Health Statistics Division, Statistics Canada
Lawson Greenberg, Unit Head, Health Statistics Division, Statistics Canada
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Health Indicators 2012
The core project team responsible for the development of this report is as follows:
Chantal Couris, Manager
Carolyn Sandoval, Project Lead
Liudmila Husak, Project Lead
Yanyan Gong, Team Lead
Erin Pichora, Senior Analyst
Jun Liang, Senior Analyst
Kathy Nguyen, Senior Analyst
Ling Yin, Senior Analyst
Opeyemi Fadahunsi, Senior Analyst
Yue You, Senior Analyst
Candace Sirjoosingh, Analyst
Viachaslau Herasimovich, Analyst
Special thanks go to Tanya Navaneelan (Analyst, Health Statistics Division, Statistics
Canada) for her contribution to historical data analysis.
The health indicators project is a joint effort by CIHI and Statistics Canada that
produces information on a broad range of health indicators. Statistics Canada
contributed indicators on health status, non-medical determinants of health and
community and health system characteristics for the Heath Indicators 2012 report,
including calculations for avoidable mortality indicators. Statistics Canada and CIHI
also jointly produce the Health Indicators e-publication, which provides additional
health indicator data.
We would also like to thank Sushma Mathur, Holly Lake, Janet Manuel, Kori Cook,
Bessie Wat, Belinda Mach and many other CIHI staff members who compiled and
validated the data; worked on the print, translation, communications, web design and
distribution; and provided ongoing support to the core team.
viii
Executive Summary
Executive Summary
Health Indicators 2012, the 13th in a series of annual reports, presents the most recent
data from the Canadian Institute for Health Information (CIHI) and Statistics Canada
on a broad range of measures. The report includes measures that will assist those
seeking answers to two fundamental questions: How healthy are Canadians? and
How healthy is the Canadian health system?
Each indicator reported falls into one of the five dimensions of the internationally
recognized Health Indicator Framework:
•
Health status— provides information about the health of Canadians, including
well-being, human function and selected health conditions.
•
Non-medical determinants of health— reflects factors outside of the health system
that affect health.
•
Health system performance— provides insight into the quality of health services,
including accessibility, appropriateness, effectiveness and patient safety.
•
Community and health system characteristics— provides contextual information,
not direct measures of health status or quality of care.
•
Equity— a cross-cutting dimension for the four above.
In addition to presenting the most recent indicator results, this report introduces a
suite of new acute-care readmission indicators, which will facilitate comprehensive
evaluation of readmissions for all patient groups, as well as three new indicators of
avoidable mortality.
Avoidable mortality refers to untimely deaths that should not occur in the presence of
timely and effective health care, including prevention. It serves to focus attention on
the portion of population health attainment that can potentially be influenced by the
health system. The three new indicators presented in the report are
•
Potentially avoidable mortality— premature deaths that could potentially have
been avoided through all levels of prevention (primary, secondary, tertiary);
•
Mortality from preventable causes— a subset of avoidable mortality that informs
efforts to reduce the number of initial cases (that is, incidence reduction); through
these efforts, deaths can be prevented by avoiding new cases altogether; and
•
Mortality from treatable causes— a subset of avoidable mortality that informs
efforts to reduce the number of people who die once they have a condition, or casefatality reduction.
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Health Indicators 2012
These new Canadian measures provide additional insight into the Canadian health
system by focusing attention on the outcomes that may be most closely associated
with prevention practices, public health policies and health care provision. As
indicators of health system performance, variations in rates of avoidable mortality
across jurisdictions identify areas where Canada’s health system has made gains, and
where gains still can be achieved. In addition to the reporting of the avoidable mortality
indicators at the national, provincial/territorial and regional levels, interpretative
analysis of these indicators is presented in the In Focus section of the report.
Highlights From In Focus—New Avoidable Mortality Health
Indicators for Canada
Premature Mortality
•
Premature mortality represents a large burden to Canadians. In 2008, more than
92,700 deaths occurred before the age of 75, which accounted for almost 40% of
all deaths in Canada. This translated to 4,471 potential years of life lost (PYLL) per
100,000 Canadians or more than 1.5 million PYLL in Canada in one year.
•
In the past 30 years, Canada has made progress in reducing premature mortality,
with rates having decreased by 45%. All provinces and most territories have seen
declines, with the largest overall declines in Yukon (56%), Quebec (49%) and
Ontario (46%).
Avoidable Mortality
x
•
There were 67,127 potentially avoidable deaths in Canada in 2008, which represents
72% of premature deaths.
•
Avoidable mortality rates were reduced by half—from 373 per 100,000 in 1979 to
185 per 100,000 in 2008.
•
The magnitude and rate of decline by cause of death varied substantially. Circulatory
diseases represented the largest cause-specific decrease (72% from 1979 to
2008). Digestive diseases and injuries also saw substantial reductions (61% and
49%, respectively).
•
Overall, rates of avoidable mortality were higher for males than females. Over the
past 30 years, rates among males have been reduced by more than half (55%)
compared with a 43% reduction among females. The narrowing gap in avoidable
mortality rates between males and females was primarily due to reductions in
mortality from circulatory disease among males.
•
International comparison shows variation in rates of potentially avoidable mortality
across G7 countries. Canada ranked third lowest, after Japan and France.
Executive Summary
Mortality From Preventable Causes
•
Mortality from preventable causes decreased by 47%—from 225 per 100,000 in
1979 to 119 per 100,000 in 2008.
•
Geographic variations in mortality from preventable causes showed higher rates
in Manitoba and Saskatchewan compared with other provinces. One of the main
drivers of provincial variations in 2008 was deaths due to injuries. Preventable
mortality rates due to injury in these provinces were about twice as high as rates
in Ontario and significantly higher than in other provinces.
•
Significant socio-economic disparities were observed. The preventable mortality
rate for people living in the least affluent neighbourhoods was almost double the
rate observed in the most affluent neighbourhoods. Disparities were even more
pronounced when the sex gap was considered; the rate for males living in the least
affluent neighbourhoods was four times higher than the rate for females living in the
most affluent neighbourhoods.
Mortality From Treatable Causes
•
In the last three decades, rates of mortality from treatable causes have decreased
by 56%—a larger decrease than that associated with rates of preventable mortality.
However, reductions in PYLL for preventable mortality were about four times larger
(2,170 per 100,000) than PYLL reduction for mortality from treatable causes (538 per
100,000), indicating that reductions in preventable mortality lead to larger gains in
potential years of life.
•
In 2008, cancers (such as breast cancer) were the main cause of death among
females, while circulatory diseases were the main cause of mortality from treatable
conditions among males.
•
Geographical variation in mortality from treatable causes was observed across
Canada and primarily reflects variation in mortality from circulatory diseases.
Saskatchewan and Manitoba had the highest rates of mortality from circulatory
diseases in 2008.
Policy Implications
•
The avoidable mortality indicators can serve to inform where Canada’s health
system has made gains and to point to where more work is needed. It can also
help to quantify potential gains. For example, in an ideal world where all avoidable
mortality in Canada would have been eliminated, life expectancy at birth for the
years 2006 to 2008 would have been 85.8 years—4.9 years longer than the
actual life expectancy of 80.9 years. Three of the 4.9 years would be attributed
to eliminating preventable mortality, and the other 1.9 years would come from
eliminating mortality from treatable causes. Analysis of avoidable mortality highlights
the need for prevention.
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Health Indicators 2012
•
Activities whose primary purpose is prevention may fall outside the jurisdiction of the
ministries of health. Intersectoral collaboration is essential in order to implement
policies outside of health care that are needed to support health. Declines in some
areas of avoidable mortality, such as circulatory diseases, resulted from the joint
efforts of preventive and curative systems; however, there is still work to be done in
the area of prevention. The smoking reduction strategies of the past several decades
are another example of what can be achieved through intersectoral collaboration.
•
Examining trends and variations in avoidable mortality could help jurisdictions
identify areas for improvement. Learning from the best, nationally and
internationally, may provide insights on successful strategies for reducing avoidable
mortality and identify areas for more detailed investigation.
•
Rates of avoidable mortality showed gradients by sex and by neighbourhood
income quintile. These indicators could be used to target public health programs
and policy development to areas where efforts are needed to close sex and
socio-economic gaps.
Highlights From Other Health Indicators
xii
•
For the most recent year of data (2010–2011), there were interjurisdictional
variations for all-cause medical, surgical, obstetric and pediatric 30-day acutecare readmission indicators. For example, for 30-day pediatric readmissions,
the rate varied across provinces from 6.0% in New Brunswick to 8.7% in
Prince Edward Island.
•
In the last 10 years, the rate for 30-day in-hospital mortality from heart attacks
has decreased by nearly one-third from 11.4% (2000–2001 to 2002–2003) to 7.8%
(2008–2009 to 2010–2011).
•
Overall, the rate of injury hospitalization in Canada decreased by 13% between
2001–2002 and 2010–2011 (from 589 to 514 per 100,000 population), after aging
and population growth were taken into account.
Health Indicator Framework
Health Indicator Framework
Health Status
How healthy are Canadians?
Health status can be measured in a variety of ways, including
well-being, health conditions, disability or death.
Well-being
Health
conditions
Human
function
Death
Non-Medical Determinants of Health
Non-medical determinants of health are known
to affect our health and, in some cases, when
and how we use health care.
Living and
working
conditions
Personal
resources
Environmental
factors
Equity
Health
behaviours
Health System Performance
How healthy is the health system?
These indicators measure various aspects
of the quality of health care.
Acceptability
Accessibility
Appropriateness
Competence
Continuity
Effectiveness
Efficiency
Safety
Community and Health System Characteristics
These measures provide useful contextual
information, but are not direct measures of
health status or the quality of health care.
Community
Health system
Resources
xiii
In Focus: Avoidable Mortality in Canada
In Focus: Avoidable Mortality in Canada
Introduction
The health care industry is one of the largest sectors of the Canadian economy,
accounting for 11.9% of gross domestic product in 2009.1 With health care spending
increasing annually in Canada and expected to have reached $200.5 billion in
2011, funders have been turning their attention to questions about health system
performance measurement to understand the value of the growing health care
expenditures to Canadians. Measuring health system performance, however, is
hardly straightforward. 2, 3
Performance indicators used to assess the many dimensions of the health system
over the years have included global measures of population health outcomes, such as
life expectancy and premature mortality. The premature mortality rate, which reflects
deaths at younger ages, has been used as an overall indicator of the health of the
population. It has guided health promotion, disease prevention and policy efforts, and
has provided an indication of where further work needs to be done to reduce mortality.
Factors that affect mortality in the population include social, economic, environmental,
biological and genetic factors. The health system also plays a role.4–6 While some
premature deaths are unavoidable, others can be potentially avoided through public
health programs and policies aimed at addressing the social determinants of health or
reducing harmful risk factors that contribute to ill health, and/or through the treatment
of the existing health condition.
Did You Know?
The terms “health system” and “health care system” are often used interchangeably in the media, everyday
discourse and health literature, yet they are distinctly different. Whereas “health care system” is meant to
reflect all that is related to the health care services provided by doctors, nurses, hospitals, emergency rooms,
rehabilitation and other services, the “health system” encompasses a broader concept. The health system,
as defined by the World Health Organization in 2000, includes “all activities whose primary purpose is to
promote, restore or maintain health.” Therefore, in addition to the provision of care, the health system also
includes public health activities of health promotion and disease prevention and other policy initiatives such as
road and environmental safety improvement, access to clean water, support for good nutrition and housing.7
The concept of avoidable mortality has gained interest in recent years for its potential
to link population health outcomes to the functioning of the health system.8–11
Avoidable mortality refers to untimely deaths that should not occur in the presence
of timely and effective health care or other public health practices, programs and
policy interventions.10, 12, 13 It is based on the understanding that, in some instances,
death can be avoided either by preventing disease onset (also known as incidence
reduction) or by averting or delaying death after a condition has developed (also known
as case-fatality reduction).14 In this way, avoidable mortality is limited to causes of
death where mechanisms of mortality reduction are known, making the measure more
“actionable” than an overall premature mortality indicator.
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Health Indicators 2012
Action-ability assumes that, once potential actions have been identified, someone
or some organization can implement an appropriate plan. For example, preventing
disease from happening can be achieved by promoting protective factors that sustain
health, and through addressing behavioural and environmental risk factors that
make people susceptible to disease. Such disease prevention efforts can range from
immunization practices and health promotion and education to global policy initiatives
such as road safety and food industry legislation. Many of these efforts—often referred
to as primary prevention—also require a will for behavioural change on the part of
individuals. On the other hand, the impact of the health care system is felt more directly
in the reduction of sickness or the number of deaths after the onset of a disease or a
health condition. These actions are also known as secondary and tertiary prevention.
To make the measure of avoidable mortality more actionable for policy-makers
and health care system managers and decision-makers, the Canadian indicator of
avoidable mortality was divided into mortality from preventable causes, which will
inform primary prevention efforts, and mortality from treatable causes, which will
inform efforts for case-fatality reduction.
Levels of Prevention Versus Levels of Care
Levels of prevention are commonly defined as14
•
Primary prevention—a condition is prevented before it develops by addressing its risk or protective factors.
The goal is incidence reduction.
•
Secondary prevention—early detection or intervention to identify a disease and delay the progression of an
early or preclinical disease and minimize disability. The goal is case-fatality reduction.
•
Tertiary prevention—interventions that lessen the impact of disability from fully developed disease through
eliminating, reducing or managing impairments. The goal is case-fatality reduction.
Levels of prevention are not necessarily the same as levels of health care delivery. For example, screening is
considered secondary prevention when targeted at the early detection of disease that already exists; however,
it is usually done in a primary health care setting.
In this report, deaths that can be avoided by preventing a disease from developing
are referred to as mortality from preventable causes. These include deaths from
conditions considerably linked to modifiable factors, such as smoking (e.g. lung cancer)
or excessive alcohol consumption (e.g. liver cirrhosis), as well as deaths related to
effective public health interventions, such as vaccinations, or traffic safety legislation
(regarding speed limits, seat belts and motorcycle helmets, for example). Deaths
from conditions such as breast cancer and appendicitis, where it is reasonable to
expect death to be averted or significantly delayed by screening, early detection and
appropriate treatment, are referred to as mortality from treatable causes. However,
it should be fully acknowledged that conditions cannot always be easily separated into
preventable and treatable categories. Also, levels of mortality from treatable causes
4
In Focus: Avoidable Mortality in Canada
are to some extent influenced by the levels of disease in the population. See Avoidable
Mortality: The Fine Print on page 7 for further methodological information and the
appendix for the list of causes of death included in the indicators.
Avoidable Mortality Indicators
Overall mortality can be split into two categories: premature deaths (occurring among those under age 75)
and deaths at older ages. Premature deaths can then be divided in two: avoidable and unavoidable.
Avoidable mortality can be further split into mortality from preventable or treatable causes. In the literature,
mortality from treatable causes is also referred to as mortality amenable to health care interventions.8, 10
The diagram below depicts how mortality was classified for the purposes of the avoidable mortality indicators.
Preventable
Avoidable
Premature
(Under Age 75)
Treatable
Unavoidable
Mortality
Age 75
and Older
Source
Adapted from Tobias, 2009.15
Like other macro-level measures, the avoidable mortality indicator can identify areas
in the health system that would benefit from further analysis and research. These
macro-level indicators are sometimes referred to as “tin-openers,”11, 16 meaning that
they are appropriate for monitoring trends and not for explaining them in full.11
Researchers have identified the following uses for these measures:
•
A monitoring indicator—a “whole-of-system health outcome indicator”—that would
act as an initial screen of health system performance;11
•
A tool to assess the quality and performance of health systems and to track changes
over time;10, 17
•
•
To estimate and track gains in population health;18 and
To identify potential gaps in health care delivery.19
5
Health Indicators 2012
There are caveats to consider when interpreting the results of any indicator, including
avoidable mortality. It is generally acknowledged, for example, that not all deaths from
potentially avoidable causes can actually be avoided. Some deaths from treatable
causes may be unavoidable due to late diagnosis or concurrent health problems. Some
deaths from preventable causes may have been the result of unpredictable events
against which no protective measures could have been taken. Researchers have also
expressed concerns about the lack of significant associations between avoidable
mortality rates and health care inputs, and have recommended further exploration of
this association.8, 20
Another caveat relates to the time between the intervention or treatment and the
impact on population mortality rates. For instance, the impact of decreased smoking on
cardiovascular diseases can take as little as one to two years to manifest itself at the
population level, but it can take up to 20 years to see tangible decreases in lung cancer
mortality.11, 21 Moreover, the concept of avoidability can change over time. A primarily
preventable condition once considered a “death sentence” for those diagnosed might
be deemed treatable years later as research and treatments advance; HIV/AIDS
serves as an example (see the case study on page 33). Finally, mortality indicators do
not represent the entire picture, given that improvements to quality of life, which are
important outcomes, are not reflected in these indicators.2
Keeping these considerations in mind, avoidable mortality is a useful performance
indicator that can focus attention on the primary purpose of health systems, namely
reducing premature death. 22 Several countries use avoidable/amenable mortality
measures for evaluating the performance of their health systems. Examples can be
found in the European Community Atlas of “Avoidable Death,”23 atlases of avoidable
mortality for Australia and New Zealand,10, 11 and the potentially avoidable deaths
indicator reported for the National Healthcare Agreements in Australia.24 The amenable
mortality indicator is also included as part of the U.K.’s National Health Service
Outcomes Framework for 2011–2012. 25 A preventable mortality indicator (yet to be
developed in the U.K.) is included under one of the domains of the Public Health
Outcomes framework. 26 Avoidable mortality indicators have also been used to report
on variations in health system performance across countries,2, 10, 17, 27, 28 as well as
variations for different areas within a country10, 29–32 and across socio-economic and
ethnic groups.10, 11, 13, 18, 33
Health Indicators 2012 takes up the challenge of reporting potentially avoidable
mortality indicators to serve as a stepping stone for continuous reporting and
monitoring of health system performance in Canada.
6
In Focus: Avoidable Mortality in Canada
Avoidable Mortality: The Fine Print
The concept of avoidable mortality dates back to 1976. At the time, American researcher David Rutstein
and his colleagues at Harvard were working on evaluating the quality of medical care for a medical audit.11, 12
Through consultation with experts, they created a list of conditions for which deaths were deemed to be
“untimely and unnecessary.”12
Since this pioneering work, the measurement of avoidable mortality has evolved, and efforts have been made
over the past 36 years to improve the indicator’s applicability to health system performance measurement.8
For example, when the concept was first developed, the upper limit for deaths considered to be premature
was 65 years of age. As life expectancy has increased in the developed world, an upper age limit of 75 was
established.10, 13 Today, age 75 is used as the upper limit; however, it is still regarded as somewhat arbitrary as
there are deaths in the over-75 population that can be avoided.34
Despite substantial research work in the area of avoidable mortality, there is currently no internationally
agreed-upon definition. To avoid duplication of efforts, the Canadian avoidable mortality indicator was
established by drawing on more than three decades of research and development, and building on the lists of
conditions used to define the Australian Potentially Avoidable Deaths indicator 24 and those proposed by the
Office of National Statistics in the U.K.34 Through careful review of the rationales for inclusion of each
condition, as well as expert review, a Canadian list of avoidable mortality was developed to include conditions
for which associated deaths were deemed potentially avoidable through prevention or treatment. Deaths were
further assigned to one of two subcategories (prevention or treatment) according to the two main mechanisms
of mortality reduction (incidence and case-fatality reduction, discussed above). In cases where there were
clear arguments for both prevention and treatment components to avoiding mortality, priority was given to
prevention. Exceptions were made where a precedent in literature existed (that is, the approach utilized a
50/50 split for deaths due to ischemic heart disease, stroke and diabetes10).
7
Health Indicators 2012
Premature Mortality
Preventable
Avoidable
Premature
(Under Age 75)
39%
Treatable
Unavoidable
Mortality
Age 75
and Older
61%
Source
2008 Vital Statistics—Death Database, Statistics Canada.
In 2008, 39% of all deaths in Canada occurred before the age of 75. Premature
mortality in Canada has been decreasing steadily over the past three decades.
After aging and population growth were taken into account, the rate decreased by
45%, from 460 per 100,000 in 1979 to 255 per 100,000 in 2008 (Figure 1). Premature
mortality rates were consistently higher for males compared with the rates for females.
However, over the past 30 years, the rate for males has decreased by 49%, while the
rate for females has decreased by 37%, resulting in a narrowing of the gap. In 1979,
the premature mortality rate for males was twice the rate for females; in 2008, the
male rate was 1.6 times the female rate.
8
In Focus: Avoidable Mortality in Canada
Figure 1: Premature Mortality, Canada, 1979 to 2008
700
Age-Standardized Rate per 100,000 Population
600
500
400
300
200
100
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
0
Overall
Male
Female
Source
Vital Statistics—Death Database, Statistics Canada.
Potential Years of Life Lost
Potential years of life lost (PYLL) is another common way to look at premature mortality. PYLL measures the
additional years a person would have lived had he or she not died prematurely (defined as deaths prior to age
75). In practice, this means that a person who died at age 25 would have lost 50 potential years of life. These
values of the difference between the actual age at death and age 75 are then summed and divided by the
population count. The earlier the age at which a death occurs, the larger the PYLL value and the larger the
loss of years of life. By taking into account the degree of prematurity, PYLL can provide information in
addition to the number of deaths per population as represented by a mortality rate.
In Canada, there were 8,639 PYLL per 100,000 population in 1979. This decreased to 4,471 PYLL per
100,000 in 2008, after aging and population growth were taken into account. This means that the 45%
reduction in the rate of premature mortality between 1979 and 2008 resulted in 4,168 fewer potential years of
life lost per 100,000. PYLL statistics for health regions, provinces and territories are provided in the tables in
this report beginning on page 50.
9
Health Indicators 2012
Over the past 30 years, rates of premature mortality have been declining in all
provinces and most of the territories,i with the largest declines in Yukon (56%),
Quebec (49%) and Ontario (46%), and the smallest in Saskatchewan (24%) (Figure 2).
In 1979, age-standardized rates of premature mortality ranged among the provinces,
from 410 per 100,000 in Saskatchewan to 499 per 100,000 in Quebec. In 2008, rates
ranged from 241 per 100,000 in Ontario and British Columbia to 313 per 100,000
in Saskatchewan.
Figure 2: Premature Mortality, by Province/Territory, 1979 to 2008
900
Age-Standardized Rate per 100,000 Population
800
700
600
500
400
300
200
100
0
N.L.
P.E.I.
N.S.
1979
N.B.
Que.
Ont.
1989
Man.
Sask.
Alta.
1999
Notes
represents 95% confi dence intervals.
Data for Nunavut and the Northwest Territories is analyzed for the period 1999 to 2008.
Source
Vital Statistics—Death Database, Statistics Canada.
i. Data for Nunavut and the Northwest Territories is analyzed for the period 1999 to 2008.
10
B.C.
2008
Y.T.
N.W.T.
Nun.
In Focus: Avoidable Mortality in Canada
Potentially Avoidable Mortality
Preventable
Avoidable
72%
Premature
(Under Age 75)
39%
Treatable
Mortality
Age 75
and Older
61%
Unavoidable
28%
Source
2008 Vital Statistics—Death Database, Statistics Canada.
While premature mortality represents all deaths before age 75, potentially avoidable
mortality (hereafter referred to as avoidable mortality) is a subset of premature deaths.
Avoidable mortality represents deaths that could have been potentially avoided through
prevention practices, public health policies, and the provision of timely and effective
health care. Avoidable mortality accounted for 72% of all premature deaths in Canada
in 2008. Given the relationship between premature and avoidable mortality, it is not
surprising that avoidable mortality rates have also decreased in the past 30 years
across Canada and within each jurisdiction. From 1979 to 2008, age-standardized
rates across Canada decreased by 50%, from 373 per 100,000 to 185 per 100,000
(Figure 3).
11
Health Indicators 2012
Figure 3: Avoidable Mortality, Canada, 1979 to 2008
600
Age-Standardized Rate per 100,000 Population
500
400
300
200
100
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
0
Overall
Male
Female
Source
Vital Statistics—Death Database, Statistics Canada.
The largest decreases in rates of avoidable mortality by jurisdiction were in Yukon,
Quebec, Ontario and British Columbia, with provincial variations remaining similar to
those observed for premature mortality (Figure 4).
12
In Focus: Avoidable Mortality in Canada
Figure 4: Avoidable Mortality, by Province/Territory, 1979 to 2008
800
Age-Standardized Rate per 100,000 Population
700
600
500
400
300
200
100
0
N.L.
P.E.I.
N.S.
N.B.
1979
Que.
Ont.
1989
Man.
Sask.
Alta.
1999
B.C.
Y.T.
N.W.T.
Nun.
2008
Notes
represents 95% confi dence intervals.
Data for Nunavut and the Northwest Territories is analyzed for the period 1999 to 2008.
Source
Vital Statistics—Death Database, Statistics Canada.
Causes of Death
A closer look at conditions that comprise avoidable mortality can help identify areas
where progress has been made and continued improvements can be realized. Figure 5
shows the proportional contribution of disease groups to overall avoidable mortality
in 1979 and in 2008. In 1979, the main causes of avoidable mortality were circulatory
diseases (42%), neoplasms (22%) and injuries (18%). Thirty years later, in 2008, while
the major causes remained the same, the proportional distribution among them had
changed. Due to substantial reductions in mortality from circulatory causes, deaths
due to neoplasms accounted for the highest percentage (35%) of avoidable mortality.
13
Health Indicators 2012
Figure 5: Avoidable Mortality, by Cause of Death, Canada, 1979 and 2008
3%
2%
2% 2% 1%
4%
1979
4%
Circulatory
42%
18%
Neoplasms
Injuries
22%
22
Infant and Maternal
Respiratory
5% 1%
Alcohol and Drugs
4%
2%
Digestive
3%
6%
Infections
25%
3%
Other
Genitourinary
16%
35
35%
2008
Note
The charts show a proportional distribution of causes of death. Therefore, an increased proportion of
neoplasms in 2008 does not mean that the rate of death due to neoplasm has actually increased.
Source
Vital Statistics—Death Database, Statistics Canada.
Figure 5 suggests that efforts to reduce mortality from circulatory diseases have had
tangible results. Over a 30-year period, avoidable mortality rates from circulatory
diseases decreased 72%, after aging and population growth were taken into account
(see Case Study: Ischemic Heart Disease). This represents the largest drop among all
causes of avoidable mortality. Avoidable mortality rates from digestive disorders (61%),
injuries (49%), alcohol and drug use (46%) and infant and maternal disorders (45%)
also saw substantial decreases, while avoidable mortality from other causes saw more
modest decreases.
14
In Focus: Avoidable Mortality in Canada
Case Study: Ischemic Heart Disease—
Preventable and Treatable
Cardiovascular diseases (CVDs) are one of the main causes of death in Canada, with ischemic heart disease
(IHD) accounting for more than 50% of all CVD deaths in 2008.35 IHD mortality rates have decreased
substantially over the past few decades.36 This overall decrease has been attributed almost equally to primary
prevention, with reductions in risk factors and changes in lifestyle (48%), and better treatment (43%).37
Controlling modifiable cardiovascular risk factors such as tobacco smoking, diabetes, elevated blood
cholesterol, high blood pressure, obesity and low physical activity has been demonstrated to reduce IHD
risk.38–40 One meta-analysis found that a reduction of one unit (1 mmol/L) in mean plasma cholesterol was
associated with about one-sixth to one-half reduction in IHD mortality, depending on age.41 The decreased
prevalence of smoking over the last five decades has also contributed to lowering the risk of ischemic heart
disease.40, 42 Though the overall prevalence of high blood pressure in Canada has been on the rise,40 a study
showed that an absolute decrease of 1.4 mm Hg in systolic blood pressure was reported between 1994 and
2005, which was associated with a 20% reduction in IHD mortality.37 Moreover, the percentage of Canadians
who are aware of their high blood pressure but are not being treated is decreasing.40
In addition to risk factor reduction strategies that target changing individuals’ behaviours, initiatives at the
population level that focus on supporting healthy behaviours also have contributed to lowering the prevalence
of many risk factors. Examples of such initiatives include the 2006 regulations governing trans fats in
processed foods, which pushed food agencies to comply with recommended levels (2% to 5% of total fat),43
and the efforts of the Health Canada–established Sodium Working Group to reduce the daily sodium intake of
Canadians.44 The availability of unhealthy foods for purchase in schools has also been under examination. In
2008, the Healthy Food for Healthy Schools Act was passed in Ontario, which required foods sold in the
province’s schools to meet a particular nutritional standard with limited trans fats.45
With respect to improvements in health care and new treatments, changes in traditional pharmacology
treatments have played a role in reducing IHD mortality.46 For example, in Ontario, use of cholesterol-lowering
medications among patients with ischemic heart disease increased from 8% to 78% between 1994 and 2005,
which was associated with a 9% mortality reduction. Treatment of acute myocardial infarction patients with
beta blockers has also grown, from 40% in 1994 to 82% in 2005.37 The timely use of thrombolytic therapy47
and interventional procedures such as percutaneous coronary intervention has also played a role in the
secondary prevention of IHD mortality.48, 49
This example illustrates how joint efforts of public health policies and effective and timely health care can
reduce mortality and bring about changes to the health of the population.
In the current Canadian definition of avoidable mortality, deaths due to IHD are assigned equally to the
treatable and preventable categories.
An additional way to gain insight into these cause-specific mortality trends is to
examine the progress of reductions in avoidable mortality by 10-year periods (see
Figure 6). These trends show that avoidable mortality rates due to circulatory diseases
had steady and consistent reductions of more than 30% each decade. The picture
is different for injuries. From 1979 to 1989, there was a 30% reduction in avoidable
mortality rates due to injuries, while reductions in the subsequent two decades were
17% and 12%, respectively (Figure 6).
15
Health Indicators 2012
Reverse trends were observed for several conditions. Specifically, after two decades
of reductions, there were increases in avoidable mortality rates from 1999 to 2008 for
infant and maternal conditions, as well as for alcohol and drug use disorders.
Despite improvements in avoidable mortality for most conditions, reductions in deaths
from circulatory causes were the main driver of the downward trend for avoidable
mortality. If mortality rates from circulatory disease remained unchanged for this
30-year period, the overall reduction in avoidable mortality would have been 19%,
and not the observed 50%.
Figure 6: Changes in Age-Standardized Rates of Avoidable Mortality From 1979
to 2008, by Cause of Death, Canada
40%
30%
Percentage Change
20%
10%
0%
Circulatory
Ci
Neop
Neoplasms
oplasms
Injur
Injuries
uries
Infant and
Maternal
Respiratory
Alcoho
Alcohol
ohol
and Drugs
Digestiv
Di
Digestive
ive
Infections
-10%
-20%
-30%
-40%
1979–1989
Source
Vital Statistics—Death Database, Statistics Canada.
16
1989–1999
1999–2008
Other
Genititour
Gen
Genitourinary
ourinar
ary
In Focus: Avoidable Mortality in Canada
Sex Gap
Avoidable mortality accounted for approximately 83% of all premature deaths among
males in 1979. By 2008, it had decreased nine percentage points to 74%. A similar
decline occurred among females during the same time period. In 1979, avoidable
mortality accounted for approximately 78% of premature deaths among females; by
2008, it accounted for 70% of premature deaths (see Figure 3). In the next section,
the sex gap for preventable and treatable mortality is examined in more depth.
Mortality From Preventable
and Treatable Causes
The concept of avoidable mortality can be more informative when mechanisms of
action can be identified. For this reason, specific sub-indicators were developed for
mortality from preventable and treatable causes.
Mortality from preventable causes (or preventable mortality) includes deaths from
diseases with well-established and significant modifiable risk factors. In the World
Health Organization’s report Global Health Risks, the leading risk factors for mortality
in higher-income countries, including Canada, were tobacco use and high blood
pressure, followed by overweight and obesity, physical inactivity, high blood glucose,
high cholesterol, low fruit and vegetable intake, exposure to urban air pollution,
alcohol use and occupational risk factors. Among high-income countries, it has been
estimated that, in 2004, these 10 risk factors accounted for 28% of deaths or 3.3 years
of life-expectancy lost.50
17
Health Indicators 2012
Case Study: Lung Cancer—Preventable
The decrease in lung cancer deaths exemplifies targeted successful intersectoral collaboration to reduce
rates of cigarette smoking—the primary risk factor associated with the disease. In Canada, lung cancer is
the leading cause of cancer mortality.51 Lung cancer mortality remains high due to the absence of reliable
screening methods to identify and treat cases in early stages.52 For example, in 2007–2008, 48% of cases in
Canada were diagnosed in stage four, the last and most advanced of four possible stages.53 Hence, the best
way to reduce mortality is to prevent the disease itself. Risk factors such as second-hand tobacco smoke and
occupational exposures,54 low fruit and vegetable consumption, and indoor radon exposure are associated
with lung cancer.52 However, globally, 71% of lung cancer cases can be attributed to smoking tobacco.50
Canada has introduced a number of policies aimed at reducing smoking prevalence and, by extension, the
illnesses associated with smoking. These include taxation increases that have seen taxes representing at
least 70% of the price of cigarettes and changes to laws banning smoking, first in government buildings,
then bans in public spaces in many municipalities across Canada.55, 56 Mass advertising campaigns and
smoking-related health education materials have evolved over the years and today target specific groups,
such as youth. There is also evidence that health care practitioners are instrumental in helping patients
quit smoking.57, 58
Over the past 50 years, smoking prevalence has dropped from 50% in 1965 to less than 20% in 2008.42 The
rate of decline has been more pronounced in males than in females; for females, the decline started later.
Given that the induction period between tobacco consumption and lung cancer development ranges from
16 to 26 years (an average of 21 years),21 the impact of smoking reductions are not seen immediately at the
population level. In fact, it was not until the late 1980s that the rate of lung cancer mortality started to decline
among males. For females, the reductions in smoking rates have not yet been translated into lung cancer
mortality reductions; however, the rate of increase has slowed in the last decade.51
The results of efforts to reduce smoking rates and therefore rates of premature death from lung cancer
demonstrate the potential for success through a combination of individual choices and behaviour changes,
and concerted and coordinated programs and policies both within and outside of the health care sector to
influence risk behaviours.
In the current Canadian definition of avoidable mortality, lung cancer is assigned to the preventable category.
The second subset of avoidable deaths—mortality from treatable causes—includes
premature deaths that potentially could be averted by screening, early detection and
successful treatment with timely and effective health care interventions. The impact
of the health care system should be felt most directly in this area of avoidable deaths,
while recognizing that other factors such as levels of disease in the population also
may influence the rates.
In 2008, preventable mortality represented 65% of avoidable mortality, and mortality
from treatable causes represented the remaining 35% of avoidable deaths in Canada.
18
In Focus: Avoidable Mortality in Canada
Preventable
65%
Avoidable
72%
Premature
(Under Age 75)
39%
Unavoidable
28%
Mortality
Treatable
35%
Age 75
and Older
61%
Note
For conditions where both prevention and treatment components to avoiding mortality exist, priority was given to
prevention (see Avoidable Mortality: The Fine Print).
Source
2008 Vital Statistics—Death Database, Statistics Canada.
Age-standardized rates for both preventable mortality and mortality from treatable
causes have been declining in Canada. Over the 30-year period from 1979 to 2008,
the preventable mortality rate decreased 47%—from 225 to 119 per 100,000—and
rates of mortality from treatable causes decreased 56%—from 149 to 66 per 100,000
(Figure 7). These reductions were also evident in the measurement of PYLL. From
1979 to 2008, PYLL decreased by 2,170 per 100,000 for preventable mortality and
by 538 per 100,000 for mortality from treatable causes. In relative terms, reductions
in PYLL were larger for preventable mortality (51%) than for mortality from treatable
causes (30% reduction). This indicates that reductions in preventable mortality lead to
larger decreases in potential years of life lost.
19
Health Indicators 2012
Figure 7: Mortality From Preventable and Treatable Causes, Canada, 1979 to 2008
Age-Standardized Rate per 100,000 Population
250
200
150
100
50
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
0
Mortality From Preventable Causes
Mortality From Treatable Causes
Source
Vital Statistics—Death Database, Statistics Canada.
Geographic Variations
In 2008, the provincial age-standardized rate of preventable mortality ranged from
107 per 100,000 in Ontario to 148 per 100,000 in Saskatchewan. For the territories, the
rate ranged from 180 per 100,000 in Yukon and the Northwest Territories to 359 per
100,000 in Nunavut (Figure 8).
20
In Focus: Avoidable Mortality in Canada
Figure 8: Preventable Mortality, by Province/Territory, 2008
500
450
Age-Standardized Rate per 100,000 Population
400
350
300
250
200
150
Canada
100
50
0
N.L. P.E.I.
N.S.
N.B. Que.
Ont. Man. Sask.
Alta.
B.C.
Y.T. N.W.T. Nun.
Note
represents 95% confi dence intervals.
Source
Vital Statistics—Death Database, Statistics Canada.
A closer look at the leading causes of preventable mortality shows that the main
driver of provincial variation in 2008 was deaths due to injuries and, to some degree,
neoplasms. Age-standardized preventable mortality rates due to injury in Manitoba
and Saskatchewan were almost twice as high as the rate in Ontario and significantly
higher than the rates in most other provinces. An east-to-west difference in the
causes of preventable mortality was also evident. Among the three leading causes
of preventable mortality, rates of death due to neoplasms were higher in the Atlantic
provinces and Quebec, while mortality rates due to injuries were higher in many of
the western provinces (Saskatchewan, Manitoba and Alberta) (Figure 9). Among other
causes of preventable death, British Columbia and Manitoba had higher rates of death
due to infections. Examining the causes of preventable mortality can help jurisdictions
identify areas where targeted prevention strategies could lead to continued reductions
in preventable mortality.
21
Health Indicators 2012
Figure 9: Preventable Mortality for Selected Causes, by Province, 2008
Age-Standardized Rate per 100,000 Population
60
50
40
30
20
10
0
N.L.
N.S.
N.B.
Neoplasms
Que.
Ont.
Man.
Injuries
Sask.
Alta.
B.C.
Circulatory
Notes
represents 95% confi dence intervals.
P.E.I. and the territories are not shown due to small number of deaths.
Source
Vital Statistics—Death Database, Statistics Canada.
There were also geographic variations in mortality from treatable causes, with
provincial rates ranging from 57 per 100,000 in British Columbia to 86 per 100,000 in
Manitoba. Examining the causes contributing to these provincial differences showed
that rates of death due to circulatory diseases were highest in Saskatchewan and
Manitoba, and mortality rates due to neoplasms and infant and maternal causes were
highest in Manitoba and Newfoundland and Labrador (Figure 10).
22
In Focus: Avoidable Mortality in Canada
Figure 10: Mortality From Treatable Causes, by Province, 2008
90
Age-Standardized Rate per 100,000 Population
80
70
60
50
40
30
20
10
0
N.L.
N.S.
N.B.
Que.
Ont.
Man.
Sask.
Alta.
Respiratory
Infections
Circulatory
Digestive
Other
Neoplasms
Genitourinary
Infant and Maternal
B.C.
Note
P.E.I. and the territories are not shown due to small number of deaths.
Source
Vital Statistics—Death Database, Statistics Canada.
While these results provide a current snapshot, provincial trends from 1979 to 2008
show improvements over time. Overall and across all jurisdictions, avoidable mortality
rates have declined. However, the gains by jurisdictions varied greatly and have been
more pronounced in mortality from treatable causes than from preventable causes
(Figure 11).
Among the provinces, decreases in age-standardized rates of preventable mortality
since 1979 were greatest in Ontario and British Columbia (51%) and Quebec (49%).
Death due to circulatory diseases was the main driver for the decrease in mortality
among all three provinces.
Over the past three decades, age-standardized rates of mortality from treatable
causes have decreased in all Canadian provinces and territories (except Nunavut).ii
For the provinces, decreases ranged from 39% in Saskatchewan to 61% in New
Brunswick and Quebec (Figure 11). In the territories, Yukon had a notable decrease
of 76%. The substantial decrease in New Brunswick can be attributed to reductions
ii. Data for Nunavut and the Northwest Territories is analyzed for the period 1999 to 2008.
23
Health Indicators 2012
in mortality due to circulatory diseases (75%) and neoplasms (53%). Quebec also
had a substantial decrease in deaths due to circulatory diseases (78%) but a smaller
decrease in mortality from neoplasms (34%). Ontario and British Columbia saw large
decreases in mortality from circulatory and digestive disorders. The decreasing rate of
deaths due to infant and maternal causes also contributed to the declines in mortality
from treatable causes in most provinces.
Figure 11: Changes in Age-Standardized Rates of Mortality From Preventable and
Treatable Causes, 1979 to 2008, by Province/Territory
N.L.
P.E.I.
N.S.
N.B.
Que.
Ont.
Man.
Sask.
Alta.
B.C.
Y.T.
0%
-10%
Percentage Change
-20%
-30%
-40%
-50%
-60%
-70%
-80%
Mortality From Preventable Causes
Mortality From Treatable Causes
Note
Data for Nunavut and the Northwest Territories is not presented as it cannot be analyzed for the whole
study period.
Source
Vital Statistics—Death Database, Statistics Canada.
Sex Gap
Between 1979 and 2008, males consistently had higher mortality rates for both
treatable and preventable causes. In fact, the preventable mortality rate for males
was more than twice that for females. Over the past 30 years, the age-standardized
rate of preventable mortality for males decreased by 52%—from 336 per 100,000 in
1979 to 161 per 100,000 in 2008. For females, the drop was much less pronounced,
24
In Focus: Avoidable Mortality in Canada
at 36%—from 122 per 100,000 in 1979 to 79 per 100,000 in 2008. The faster rate of
decline for preventable mortality for males has resulted in a narrowing of the sex gap
(Figure 12 A).
Overall, the sex gap has been much narrower historically for mortality from treatable
causes than from preventable causes and has remained fairly narrow over time
(Figure 12 B). In 1979, the male–female ratio was 1.5; in 2008, it had changed a
fraction to 1.2. Over the last 30 years, age-standardized rates of mortality from
treatable causes dropped by 59% for males—from 179 per 100,000 in 1979 to 73
per 100,000 in 2008. The rate for females saw a reduction of 51%—from 122 per
100,000 in 1979 to 60 per 100,000 in 2008 (Figure 12 B).
Figure 12: Mortality From Preventable and Treatable Causes, by Sex, Canada,
1979 to 2008
Age-Standardized Rate per 100,000 Population
Age-Standardized Rate per 100,000 Population
A. Mortality From Preventable Causes
400
400
350
300
250
200
150
100
50
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
0
B. Mortality From Treatable Causes
350
300
250
200
150
100
50
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
0
Male
Female
Source
Vital Statistics—Death Database, Statistics Canada.
25
Health Indicators 2012
A closer look at the causes of mortality from preventable and treatable causes
provides further insight into the sex gaps. In 2008, male rates of preventable
mortality from alcohol and drug use disorders and injuries were more than 2.5 times
the rate for females. The male mortality rate from circulatory diseases was 2.4 times
the rate for females, while the mortality rate from preventable cancers (mainly lung
cancer) was 1.6 times higher. In terms of the trend over time, similar decreases were
observed for most causes of preventable deaths for both males and females. For
cancers and respiratory disorders, mortality rates for females have increased since
1979 (Figure 13).
For mortality from treatable causes in 2008, neoplasms (see Case Study: Breast
Cancer) were the main causes of death among females, while circulatory diseases
were the main causes of mortality from treatable conditions among males (Figure 14).
Case Study: Breast Cancer—Treatable
Breast cancer mortality in Canada has been significantly impacted by early detection through case-finding
and treatment. In Canada, a woman’s lifetime probability of developing breast cancer is 1 in 9, with a 1 in
29 chance of dying from it. It is the second most common cause of cancer deaths in women.51 Several of the
key risk factors for developing breast cancer, including older age and family history of breast cancer, are not
modifiable.52 Modifiable risk factors (such as alcohol consumption, hormone replacement therapy and physical
inactivity) account for approximately 27% of new breast cancer cases.59 As a result, efforts to improve breast
cancer survival in recent years have focused on identifying cases at the early stages through screening,
as well as on new treatments for breast cancer (use of adjuvant therapies such as hormonal therapy,
chemotherapy and radiotherapy following surgery).51, 60, 61 If detected and treated in stage one (the earliest of
four stages), breast cancer has a five-year relative survival rate of 100%, while if detected in stage four, the
survival rate drops to 19.9%.62
The first formal mammography screening program for breast cancer was established in 1988 in British
Columbia. Other provinces soon followed and programs received a major funding boost in 1992 with the
launch of the Canada Breast Cancer Initiative.63 In 2008, 72.5% of women age 50 to 69 reported having
had a mammogram in the past two years, which translates to approximately 2.8 million mammograms.64
Mortality from breast cancer has been declining since the late 1980s/early 1990s. During the same time
period, the incidence of breast cancer increased and has since remained stable. The observed trend in
incidence is due to a combination of increasing mammography screening uptake and fluctuating patterns
in the use of hormone replacement therapy.51 The combination of a declining mortality with an increase in
incidence suggests that improved survival may account for the decline in the breast cancer mortality rate.
In the current Canadian definition of avoidable mortality, breast cancer is assigned to the treatable category
because of the evidence for the impacts of screening mammography and treatment.61
26
In Focus: Avoidable Mortality in Canada
Figure 13: Mortality From Preventable Causes, by Sex, Canada, 1979 and 2008
Age-Standardized Rate per 100,000 Population
350
300
15
19
250
75
200
93
8
11
150
51
100
50
12
122
22
32
46
1979
3
7
32
17
14
2008
50
33
0
5
5
2008
1979
Male
Female
Infections
Digestive
Respiratory
Injuries
Other
Alcohol and Drugs
Neoplasms
Circulatory
Source
Vital Statistics—Death Database, Statistics Canada.
Figure 14: Mortality From Treatable Causes, by Sex, Canada, 1979 and 2008
Age-Standardized Rate per 100,000 Population
180
160
140
120
10
15
23
5
100
12
80
47
60
11
114
8
16
40
20
6
7
45
28
1979
2008
31
4
12
0
1979
2008
Male
Female
Genitourinary
Digestive
Infections
Neoplasms
Respiratory
Other
Infant and Maternal
Circulatory
Source
Vital Statistics—Death Database, Statistics Canada.
27
Health Indicators 2012
Socio-Economic Disparities
For both preventable mortality and mortality from treatable causes, there were
gradients in the rates by socio-economic group, as measured by neighborhood
income quintile. Mortality rates were consistently higher among people living in the
least affluent neighbourhoods, with rates gradually decreasing as socio-economic
status increased. Socio-economic gradients were steeper for preventable mortality
than for mortality from treatable causes. In the period 2005 to 2007, the agestandardized rate of preventable mortality for people living in the least affluent
neighbourhoods was almost twice the rate in the most affluent neighbourhoods.
For mortality from treatable causes, this ratio was 1.6 (Figure 15).
Disparities for preventable mortality were even more pronounced when the sex gap
was considered: the rate for males living in the least affluent neighbourhoods was
four times higher than the rate for females living in the most affluent neighbourhoods.
For mortality from treatable causes, this ratio was 2.
Figure 15: Mortality From Preventable and Treatable Causes, by Neighbourhood
Income Quintile, Canada, 2005 to 2007
200
Age-Standardized Rate per 100,000 Population
180
172
160
132
140
116
120
100
107
88
87
80
71
64
60
60
54
40
20
0
1—Least Affluent
2
3
4
Neighbourhood Income Quintile
Preventable
Treatable
Notes
represents 95% confi dence intervals.
Rates are calculated based on three years of pooled data (2005 to 2007).
Source
Vital Statistics—Death Database, Statistics Canada.
28
5—Most Affluent
In Focus: Avoidable Mortality in Canada
How Does Canada Compare Internationally?
When data is available, international comparisons provide an additional perspective on
how Canada’s health system is performing, relative to other industrialized countries.
In order to compare Canada’s rates of avoidable mortality with those of other
G7 countries, the mortality database of the World Health Organization (WHO) was
used and the Canadian definition of avoidable mortality was applied to the other
countries. This database hosts data from the national vital registration systems
of the different countries. Due to the nature of the database, it was not possible
to apply the Canadian definition to calculate results for preventable and treatable
subsets of avoidable mortality, or to calculate time trends for data that used the
ICD-9 coding system. 2004 was the latest common year for which data was available
in all G7 countries, except Italy.
Using this methodology, in 2004, the United States had the highest avoidable mortality
rate of 271 per 100,000 population; Japan had the lowest rate of 170 per 100,000.
Canada ranked third lowest, after Japan and France (Figure 16).
While comparing Canada’s avoidable mortality rate to that of other countries
provides an overall picture, comparing provincial results can provide insight into
the performance of the provincial health systems. For example, Newfoundland and
Labrador’s rate of avoidable mortality in 2004 (228 per 100,000) was about the
same as that of the U.K. (225 per 100,000)—the second worst performer among
G7 countries—while British Columbia (183 per 100,000) had a rate similar to that of
France (180 per 100,000)—the second best performer.
International comparisons are not without challenges and cautions, particularly given
that there is no internationally agreed-upon definition for this indicator. There may be
cross-national differences in coding practices, and timeliness of the data is often an
issue. Despite these challenges, international comparisons remain of interest when
assessing health system performance.
29
Health Indicators 2012
Figure 16: Avoidable Mortality, G7 Countries, 2004
300
Age-Standardized Rate per 100,000 Population
250
200
150
100
50
0
U.S.
U.K.
Germany
Canada
France
Japan
Notes
represents 95% confi dence intervals.
Rates were age-standardized to 1991 Canadian standard population using direct method
of standardization.
2004 data for Italy was not available.
Source
WHO, Department of Health Statistics and Informatics Mortality Database.
Summary
In 2008, there were more than 238,600 deaths in Canada, 39% of which were among
those under the age of 75. Of these premature deaths, it is estimated that 72% were
potentially avoidable, with 65% of these being preventable and 35% treatable.
These 2008 rates, both for males and females, are substantially lower than the
rates seen in 1979. On all measures—avoidable mortality and mortality from both
preventable and treatable causes—age-standardized death rates and potential years
of life lost have decreased over the past 30 years. The magnitude and rate of decline
by cause have varied substantially. Deaths due to circulatory diseases and injuries
had the most significant decreases. In 2008, cancers, injuries and circulatory diseases
were the main causes of preventable mortality for both males and females. Circulatory
diseases played a larger role in mortality from treatable causes among males, whereas
for females it was cancer.
30
In Focus: Avoidable Mortality in Canada
As others who have looked at avoidable mortality have found, aggregate measures
conceal a great deal of variation. This is also true in looking at avoidable deaths on a
national scale. Across the Canadian provinces, rates of avoidable mortality in 2008
varied from 173 per 100,000 in Ontario and British Columbia to 229 per 100,000 in
Manitoba. For preventable causes, provincial rates ranged from 107 per 100,000 in
Ontario to 148 per 100,000 in Saskatchewan, and for treatable causes from 57 per
100,000 in British Columbia to 86 per 100,000 in Manitoba.
Socio-economic disparities and sex gaps for avoidable mortality were also identified,
with rates being higher among males than females and for those living in the
least affluent neighbourhoods (compared with those living in the most affluent
neighbourhoods). The gaps for preventable mortality were more pronounced than for
mortality from treatable causes. Noting that variation in morbidity rates will account for
some of the variation, additional examination of these measures at the jurisdiction level
and by contributing conditions can serve to inform policy.17
Implications for Health and Social Policy
and the Provision of Care
Consistent with the application of the concept of reducing avoidable deaths in other
countries, the new avoidable mortality indicators provide additional insight into the
Canadian health system. These measures can be used to assess the impact of
prevention strategies and the outcomes of health policy decisions and health care
provision. The avoidable mortality indicators can serve to inform where Canada’s
health system has made gains and to point to where more work is needed. It can also
help to quantify potential gains. For example, in an ideal world where all avoidable
mortality in Canada would have been eliminated, life expectancy at birth for the years
2006 to 2008 would have been 85.8 years—4.9 years longer than the actual life
expectancy of 80.9 years. Three of the 4.9 years would be attributed to eliminating
preventable mortality, and the other 1.9 years would come from eliminating mortality
from treatable causes. This larger potential gain from eliminating preventable mortality
emphasizes the need to focus on disease prevention.
A plea for prevention. The 1974 Lalonde report, based on data from 40 years ago,
highlighted the “paradox of everyone agreeing to the importance of research and
prevention yet continuing to increase disproportionately the amount of money spent
on treating existing illness.”4 Quantifying avoidable mortality for Canadian jurisdictions
and dividing avoidable mortality into mortality from treatable and from preventable
causes highlights once again the importance of prevention. While declines in some
areas of avoidable mortality, such as circulatory diseases, resulted from the joint
efforts of preventive and curative systems, there is still work to be done in the area
of prevention. For example, higher rates among males in avoidable mortality can be
attributed primarily to the higher rates of the preventable subset of avoidable mortality.
Furthermore, the female rate of mortality from preventable causes differs only slightly
31
Health Indicators 2012
from the rate from treatable causes, while for males the rate of preventable mortality is
more than twice the rate of mortality from treatable causes. This highlights a significant
area for potential health gains.
With respect to the preventable causes of mortality, a large body of literature has
explored the links between health behaviours, risk-factor reduction strategies
and health outcomes. Where this knowledge is available and variation in rates of
preventable causes of mortality are found, targeted (therefore, more cost-effective)
risk-factor reduction strategies may be supported. For example, higher rates of
avoidable mortality among males can be attributed primarily to their higher rates of
preventable deaths. The introduction of graduated licences, for example, that limit
riskier night-time driving among young and new drivers has resulted in saved lives and
reductions in the need for more costly (and not guaranteed as successful) treatment
options once an incident occurs.65
Need for collaboration. Given the broad definition of the health system, activities
whose primary purpose is to promote health may fall outside the jurisdiction of the
ministries of health. Continued dialogue is essential in order to identify and address
policies outside of health care that are needed to support health. The tobacco
reduction strategies of the past several decades best exemplify what can be achieved
through intersectoral collaboration.55
Awareness of variation and past trends. Policy-makers, and health care planners
and providers require factual information on the magnitude and variation in avoidable
mortality rates. Variation in rates of avoidable mortality across Canada flag possible
issues and identify areas for more detailed investigation. Examining variations in the
causes of avoidable mortality could help jurisdictions identify areas for improvement.
Examination of the trends in avoidable mortality could also provide insight on the areas
where progress has been made and where continued improvements are needed.
Jurisdictions that have seen significant gains may have important knowledge to share
about their approach with those jurisdictions where gains have been less striking.
Addressing health disparities. Rates of avoidable mortality overall and for
most causes show gradients by neighbourhood income quintile, as do many other
health system performance measures. The gap between socio-economic groups
is most pronounced for mortality from preventable causes. The reduction of health
disparities has emerged as a major and worldwide public health objective66, 67 that
spans prevention, access to health care and the provision of care. This indicator and
cause-specific avoidable mortality measure could be used to target public health
programs and policy development to areas where significant gains need to be realized
to close the gap.
32
In Focus: Avoidable Mortality in Canada
Future research. Future research should seek to understand more clearly the
relationship between avoidable mortality rates and specific prevention strategies and
specific health care interventions. As research more clearly identifies the link between
prevention, treatment efforts and avoidable mortality, the definition of the indicators will
need to be reviewed and revised. This final case study on HIV/AIDS demonstrates how
the definition of avoidable mortality may evolve over time.
Case Study: HIV—When Preventable and Treatable
Change Over Time
The case of HIV/AIDS provides an interesting picture of a condition for which “preventability” and “treatability”
have changed over time. On a global scale, the condition can be described as having undergone five periods:
silent spread, recognition, intense discovery, global mobilization and discoveries of ending the problem
(through public education, blood testing and antiviral treatment).68 When Canada’s first HIV case was
diagnosed in 1982,69 the disease’s cause and mode of transmission were unknown and treatment options
were limited. As a result, mortality ratesiii were high. Once the modes of disease transmission and spread
were determined in the mid-1980s,68, 70 it became apparent that HIV/AIDS could be prevented through
protected sex, safe blood transfusions and general avoidance of the modes of transmission, making
prevention the most significant, and possibly the only, way to reduce mortality.
The most notable decreases in the incidence of HIV/AIDS occurred among men who have sex with men
(MSM). In the early 1980s, 80% of all reported cases were among this group.71 Recent statistics from 2009
show that the number of reported HIV cases among MSM has decreased and the group now accounts for
less than half (42%) of all cases.71, 72 Decreases in the number of reported cases also occurred among other
exposure categories, including injection drug users.71, 72 Preventive efforts and educational initiatives may
have had a role in the decrease in reported HIV cases.73, 74
A major treatment breakthrough, however, occurred in the mid-1990s, when new highly active antiretroviral
therapy (HAART) was shown to be associated with a decrease in incidence of opportunistic infections, thus
resulting in lower mortality rates.68, 75, 76 After the introduction of HAART, the number of AIDS cases in Canada
declined remarkably between 1996 and 1998.71 The effect of HAART treatment is also reflected in the
Canadian mortality rates for HIV/AIDS, which echoes the AIDS incidence pattern.
In the current Canadian definition of avoidable mortality, HIV/AIDS is assigned to the preventable category
because of its highly preventable nature. However, this case study highlights the need for periodic review of
the indicator definitions as an understanding of etiology and treatment options evolve over time.77
iii.
Age-standardized mortality rates were calculated with the WHO’s Department of Health Statistics and
Informatics Mortality Database (July 1, 2010, update) and Statistics Canada’s CANSIM Table 102-0521.
33
Appendix
Appendix: List of Causes of Death
for Avoidable Mortality Indicator
Causes of Death
ICD-9 Codes
ICD-10 Codes
Enteritis and other
diarrhoeal disease
001–009
A00–A09
Tuberculosis
010–018
137
A16–A19
B90
J65
Preventable
(Incidence
Reduction)
Treatable
(Case-Fatality
Reduction)
Infections
Vaccine-preventable 032, 033, 036 ,037
diseases
038.2
041.5, 045
052, 055, 056
481, 482.2, 487
320.0, 320.1
A35–A37, A39
A40.3, A41.3
A49.2, A80
B01, B05, B06
J09–J11, J13, J14
G00.0, G00.1
x
x
x
Selected invasive
bacterial infections
034.1
482.8
041.0
A38,
A48.1
A49.1
x
Sepsis
038 (except 038.2)
A40 (except A40.3)
A41 (except A41.3)
x
Malaria
084
B50–B54
x
Meningitis
320.2,3,8,9
G00.2,3,8,9
x
Cellulitis
035
681, 682
A46
L03
x
Pneumonia
480, 482.0,1,3,4
483, 485, 486, 514
J12, J15, J16, J18
x
Sexually transmitted 131, 054.1,7
infections,
078.1, 090–098
except HIV/AIDS
099.0,1,2,8,9
A50–A60, A63, A64
x
Viral hepatitis
070
B15–B19
x
HIV/AIDS
042.0–044.9
B20–B24
x
Lip, oral cavity
and pharynx cancer
140–149
C00–C14
x
Esophageal cancer
150
C15
x
x
Neoplasms
Stomach cancer
151
C16
Colorectal cancer
153, 154
C18–C21
Liver cancer
155
C22
x
Lung cancer
162
C33, C34
x
Melanoma
skin cancer
172
C43
x
Non-melanoma
skin cancer
173
C44
x
Malignant
neoplasm of breast
174
C50
x
(female only)
x
Cervical cancer
180
C53
x
Uterus cancer
179, 182
C54, C55
x
Testicular cancer
186
C62
x
35
Health Indicators 2012
Causes of Death
Preventable
(Incidence
Reduction)
Treatable
(Case-Fatality
Reduction)
ICD-9 Codes
ICD-10 Codes
Bladder cancer
188
C67
x
Thyroid cancer
193
C73
x
Hodgkin’s disease
201
C81
x
Leukemia
204.0,1; 205.1
C91.0, C91.1, C92.1
Benign neoplasms
210–229
D10–D36
Neoplasms (cont’d)
x
(age <45)
x
Diseases of the Circulatory System
Rheumatic
heart disease
391–398
I01, I02, I05–I09
Hypertensive
diseases
401
402–405
I10
I11–I13, I15
Cerebrovascular
diseases
430–432
433, 434, 436–438
I60–I62
I63–I64, I67, I69
x (50%)
x (50%)
Ischaemic
heart disease
410–414
423.0,9; 429.5,6,8
I20–I25
x (50%)
x (50%)
Other
atherosclerosis
440, 443.9
I70, I73.9
x (50%)
x (50%)
Aortic aneurysm
441
I71
x
Venous
thromboembolism
415
451
453.9
I26
I80
I82.9
x
x
x
x
Diseases of the Respiratory System
36
Chronic obstructive
pulmonary
disorders
490–492, 496
J40–J44
Asthma and
bronchiectasis
493, 494
J45, J47
x
Acute lower
respiratory
infections
466.0
J20, J22
x
Upper respiratory
infections
034.0, 460–465
470–478
J00–J06
J30–J39
x
Lung diseases due
to external agents
117.3, 495
500–508
511.0, 518.3
C45, J60–J64,
J66–J70, J82, J92
Adult respiratory
distress syndrome
518.5
J80
x
Pulmonary oedema
518.4
J81
x
Abscess of lung
and mediastinum;
pyothorax
513, 510
J85, J86
x
Other pleural
disorders
511.9, 512
J90, J93, J94
x
Other respiratory
disorders
518.0,1,2,8
519.1,3,4,8,9
J98
x
x
Appendix
Causes of Death
ICD-9 Codes
ICD-10 Codes
Preventable
(Incidence
Reduction)
Treatable
(Case-Fatality
Reduction)
Diseases of the Digestive System
Peptic ulcer disease 531–534
K25–K28
x
x
Diseases of
appendix; hernia;
disorders of
gallbladder, biliary
tract and pancreas
540–543
550–553
574–576
577
K35–K38
K40–K46
K80–K83
K85.0,1,3,8,9
K86.1,2,3,8,9
Chronic
liver disease
(excluding alcoholrelated disease)
571.4,5,9
K73, K74.0,1,2,6
x
Diseases of the Genitourinary System
Nephritis
and nephrosis
580–583
N00–N07
x
Renal failure
584–586
N17–N19
x
Obstructive
uropathy,
urolithiasis
and prostatic
hyperplasia
590.8, 591, 592
593.3,5,7; 594
598, 599.6, 600
N13, N20, N21, N23
N35, N40
x
Inflammatory
diseases of genitourinary system
099.4, 614, 615
616.0,2,3,4,5
N34.1, N70–N73
N75.0, N75.1, N76.4
N76.6
x
Disorders resulting
from impaired renal
tubular function
588
N25
x
771.3
A33
x
363.4
760–779
(except 779.4)
H31.1
P00–P96
Congenital
malformations,
deformations and
chromosomal
anomalies
740–759
Q00–Q99
x
Pregnancy,
childbirth and the
puerperium
630–676
O00–O99
x
Transport accidents
E800–E848
V01–V99
x
Falls
E880–E886, E888
W00–W19
x
Other external
causes of
accidental injury
E887, E900–E909
E911–E928
W20–W64
W75–W99
X10–X39, X50–X59
x
Drowning
E910
W65–W74
x
Fires and flames
E890–E899
X00–X09
x
Accidental
poisonings
E850–E858
E860–E869
X40–X49
x
Infant and Maternal Causes
Complications of
perinatal period
x
Unintentional Injuries
37
Health Indicators 2012
Causes of Death
ICD-9 Codes
ICD-10 Codes
Preventable
(Incidence
Reduction)
Treatable
(Case-Fatality
Reduction)
Injuries of Undertermined Intent
Injuries of
E980–E989
undetermined intent
Y10–Y34
x
Intentional Injuries
Suicide and selfinflicted injuries
E950–E959
X60–X84, Y87.0
x
Assault
E960–E969
X85–X99
Y00–Y09, Y87.1
x
Alcohol and Drug Use Disorders
Alcohol-related
diseases, excluding
external causes
291, 303, 305.0
357.5, 425.5
535.3
571.0,1,2,3
F10, G31.2
G62.1, I42.6
K29.2
K70, K85.2, K86.0
x
Drug use disorders
292, 304
305 (except
305.0,1)
F11–F16, F18, F19
x
Nutritional, Endocrine and Metabolic Disorders
Nutritional
deficiency anaemia
280, 281
D50–D53
Thyroid disorders
240.0,9
241.0,1,9
242–246
E00–E07
Diabetes mellitus
250
E10–E14
x
x
x (50%)
x (50%)
Adrenal disorders
255
E24, E25, E27
x
Congenital
metabolic disorders
271.0,1
E74.0, E74.2
x
G40, G41
x
M86
x
Neurological Disorders
Epilepsy
345
Disorders of Musculoskeletal System
Osteomyelitis
730.0,1,2,3
Adverse Effects of Medical and Surgical Care
Drugs, medicaments E930–E949
and biological
substances causing
adverse effects in
therapeutic use
38
Y40–Y59
x
Misadventures to
patients during
surgical and
medical care
E870–E876
Y60–Y66, Y69
x
Medical devices
associated with
adverse incidents
in diagnostic and
therapeutic use
No corresponding
codes
Y70–Y82
x
Surgical and other
medical procedures
as the cause of
abnormal reaction
E878, E879
Y83, Y84
x
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44
Health Indicators
Region by Region
Health Indicators 2012
Health indicators are standardized measures of various aspects of health and
health care that can be used to monitor the health status of the population and the
performance and characteristics of the health system over time and across the
country. As in previous years, the Health Indicators annual report provides up-to-date
comparable information for health regions, provinces and territories. This information
can be used by jurisdictions to evaluate progress and identify areas for improvement.
There’s More on the Web
CIHI and Statistics Canada jointly produce and maintain the Health Indicators e-publication. This free
web-based product provides data for a broad range of health indicators from both CIHI and Statistics
Canada in one integrated online publication. This interactive online resource provides easy access to the
most recent health indicator results, as well as to data for all available years, maps, technical notes and
other important information.
Health Indicators e-publication: To find more information on the latest readings on the health of
Canadians—region by region—please visit www.cihi.ca/indicators or www.statcan.gc.ca.
What Are Health Regions?
Health regions are administrative bodies, legislated by the provincial ministries of
health. They are defined by geographical areas and are responsible for providing
health services to their residents. The role of health regions in determining how
resources are allocated and their relationship with local hospitals vary by province.
For this report, data is provided for all regions with a population of at least 50,000.
In addition, data for the smaller regions, as well as for Nova Scotia zones and
Ontario public health units, is included in the Health Indicators e-publication
(www.cihi.ca/indicators or www.statcan.gc.ca). Please see page 104 for a map
of all the health regions in Canada.
Interpreting the Indicators
Unless otherwise specified, health indicators are reported based on where a patient
lives, not where he or she was hospitalized. Consequently, these figures reflect the
experience of residents of a region regardless of where they were treated, even if it
was outside their own province, rather than showing the activity of hospitals in a given
region. Confidence intervals are provided for most indicators to aid interpretation. The
width of the confidence interval illustrates the degree of variability associated with
the rate. Indicator values are estimated to be accurate within the upper and lower
confidence intervals 19 times out of 20 (95% confidence interval).
46
Health Indicators: Region by Region
Symbols and Abbreviations
..
*
Figures not available
Figures suppressed due to small numbers or incomplete data
&
Interpret with caution
95% CI
95% confidence interval
Statistically significantly different from the national (Canada) rate (p≤0.05)
ASSS
Agence de la santé et des services sociaux
HSDA
Health service delivery area
LHIN
Local health integration network
RHA
Regional health authority
47
Health Indicators 2012
Population
(’000)
Population
Age 65+
(%)
Dependency
Ratio
2010
511
303
93
77
2010
15.4
14.2
18.3
17.7
2010
56.3
53.6
61.8
61.4
Map
Code Health Region
Newfoundland and Labrador
1011 Eastern Regional Integrated Health Authority
1012 Central Regional Integrated Health Authority
1013 Western Regional Integrated Health Authority
Legend Name
N.L.
Eastern
Central
Western
Prince Edward Island
P.E.I.
144
15.6
64.0
Nova Scotia
1211 South Shore District Health Authority
1212 South West Nova District Health Authority
1223 Annapolis Valley District Health Authority
1234 Colchester East Hants Health Authority
1258 Cape Breton District Health Authority
1269 Capital District Health Authority
N.S.
South Shore
South West Nova
Annapolis Valley
Colchester East Hants
Cape Breton
Capital
946
58
59
83
74
123
423
16.2
20.9
18.9
18.3
16.3
19.0
12.8
59.3
63.4
65.8
68.0
64.2
68.1
51.3
New Brunswick
1301 Zone 1
1302 Zone 2
1303 Zone 3
1306 Zone 6
N.B.
Zone
Zone
Zone
Zone
754
204
176
174
78
15.9
15.7
15.3
14.4
18.0
59.3
56.5
62.2
58.9
57.3
Quebec
2401 ASSS
2402 ASSS
2403 ASSS
2404 ASSS
2405 ASSS
2406 ASSS
2407 ASSS
2408 ASSS
2409 ASSS
2411 ASSS
2412 ASSS
2413 ASSS
2414 ASSS
2415 ASSS
2416 ASSS
Que.
Bas-Saint-Laurent
Saguenay–Lac-Saint-Jean
Capitale-Nationale
Mauricie et Centre-du-Québec
Estrie
Montréal
Outaouais
Abitibi-Témiscamingue
Côte-Nord
Gaspésie–Îles-de-la-Madeleine
Chaudière-Appalaches
Laval
Lanaudière
Laurentides
Montérégie
7,929
201
273
694
495
310
1,934
364
146
96
94
405
399
464
549
1,441
15.4
18.7
17.0
16.9
18.3
16.6
15.0
12.4
14.5
13.8
19.5
16.0
15.4
13.9
14.1
14.6
59.4
63.1
61.4
56.6
64.0
63.1
54.7
55.5
62.0
60.3
60.8
62.1
64.4
60.6
60.7
61.6
13,286
643
952
747
1,404
842
1,157
1,185
1,733
1,553
489
1,245
455
565
240
14.0
15.5
15.5
12.5
15.7
10.7
11.0
13.7
12.3
14.1
17.5
13.7
15.6
17.4
14.8
59.3
65.3
64.2
58.9
63.9
57.0
58.4
52.6
55.9
58.3
63.9
57.1
64.0
63.3
64.8
1,239
698
51
68
83
109
70
13.9
13.9
14.8
10.7
15.7
13.3
18.8
66.3
58.9
63.2
75.6
71.7
79.9
79.8
du Bas-Saint-Laurent
du Saguenay–Lac-Saint-Jean
de la Capitale-Nationale
de la Mauricie et du Centre-du-Québec
de l’Estrie
de Montréal
de l’Outaouais
de l’Abitibi-Témiscamingue
de la Côte-Nord
de la Gaspésie–Îles-de-la-Madeleine
de Chaudière-Appalaches
de Laval
de Lanaudière
des Laurentides
de la Montérégie
1
2
3
6
(Moncton area)
(Saint John area)
(Fredericton area)
(Bathurst area)
Ontario
3501 Erie St. Clair LHIN
3502 South West LHIN
3503 Waterloo Wellington LHIN
3504 Hamilton Niagara Haldimand Brant LHIN
3505 Central West LHIN
3506 Mississauga Halton LHIN
3507 Toronto Central LHIN
3508 Central LHIN
3509 Central East LHIN
3510 South East LHIN
3511 Champlain LHIN
3512 North Simcoe Muskoka LHIN
3513 North East LHIN
3514 North West LHIN
Ont.
Erie St. Clair
South West
Waterloo Wellington
Hamilton Niagara Haldimand Brant
Central West
Mississauga Halton
Toronto Central
Central
Central East
South East
Champlain
North Simcoe Muskoka
North East
North West
Manitoba
4610 Winnipeg RHA
4615 Brandon RHA
4625 South Eastman Health
4630 Interlake RHA
4640 RHA—Central Manitoba Inc.
4645 Assiniboine RHA
Man.
Winnipeg
Brandon
South Eastman
Interlake
Central
Assiniboine
48
Health Region Profile
Map
Code
Health Region
Population
(’000)
Population
Age 65+
(%)
Dependency
Ratio
Legend Name
2010
2010
2010
Saskatchewan
4701 Sun Country Health Region
4702 Five Hills Health Region
4704 Regina Qu’Appelle Health Region
4705 Sunrise Health Region
4706 Saskatoon Health Region
4709 Prince Albert Parkland RHA
4710 Prairie North Health Region
Sask.
Sun Country
Five Hills
Regina
Sunrise
Saskatoon
Prince Albert
Prairie North
1,048
54
53
260
54
315
78
71
14.6
16.9
18.9
13.7
21.9
12.8
15.5
12.9
68.6
73.9
74.6
61.7
83.0
60.8
80.2
77.3
Alberta
4831 South Zone
4832 Calgary Zone
4833 Central Zone
4834 Edmonton Zone
4835 North Zone
Alta.
South Zone
Calgary Zone
Central Zone
Edmonton Zone
North Zone
3,735
282
1,388
452
1,174
426
10.7
13.6
9.6
12.4
11.1
9.0
54.9
66.5
50.5
62.3
53.0
60.4
British Columbia
5911 East Kootenay HSDA
5912 Kootenay Boundary HSDA
5913 Okanagan HSDA
5914 Thompson Cariboo Shuswap HSDA
5921 Fraser East HSDA
5922 Fraser North HSDA
5923 Fraser South HSDA
5931 Richmond HSDA
5932 Vancouver HSDA
5933 North Shore/Coast Garibaldi HSDA
5941 South Vancouver Island HSDA
5942 Central Vancouver Island HSDA
5943 North Vancouver Island HSDA
5951 Northwest HSDA
5952 Northern Interior HSDA
5953 Northeast HSDA
B.C.
East Kootenay
Kootenay Boundary
Okanagan
Thompson/Cariboo/Shuswap
Fraser East
Fraser North
Fraser South
Richmond
Vancouver
North Shore
South Vancouver Island
Central Vancouver Island
North Vancouver Island
Northwest
Northern Interior
Northeast
4,550
80
80
351
223
285
610
714
197
659
285
372
265
121
76
144
69
15.0
16.1
18.3
20.2
17.0
14.4
11.7
15.6
12.7
12.0
15.4
17.2
20.0
17.1
11.7
11.9
8.7
57.2
60.8
62.9
67.5
62.4
65.2
50.2
66.5
51.6
41.6
58.2
55.4
66.7
63.3
62.8
58.0
58.8
Yukon
Y.T.
35
8.5
47.6
Northwest Territories
N.W.T.
44
5.5
55.4
Nunavut
Nun.
33
3.1
79.8
Canada
Canada
34,254
14.2
59.0
Population
The number of people living in a geographic area. A population’s size and age–sex composition may affect the health status of a region and
its need for health services. Population data also provides the denominators used to calculate rates for most health and social indicators.
Sources: Demography Division, Statistics Canada. Data is derived from the census and administrative sources on births, deaths and migration. Population
estimates for health regions in B.C. were provided by BC Stats. Population estimates for health regions in Quebec were derived from census division
population estimates provided by the Institut de la statistique du Québec.
Dependency ratio
The ratio of the combined population age 0 to 19 and the population age 65 and older to the population age 20 to 64. This ratio is presented
as the number of dependants for every 100 people in the working-age population. Canadians age 65 and older and those younger than age
20 are more likely to be socially and/or economically dependent on working-age Canadians, and they may also put additional demands on
health services.
Source: Demography Division, Statistics Canada.
49
Health Indicators 2012
Premature Mortality
2006 –2008
Map
Code
Health Region
Newfoundland and Labrador
1011 Eastern
1012 Central
1013 Western
Age-Standardized Mortality
Rate per 100,000
95% CI
Age-Standardized PYLL†
per 100,000
95% CI
307
309
281
310
(298–315)
(298–320)
(263–298)
(290–331)
5,317
5,183
4,811
5,497
(5,067–5,567)
(4,865–5,501)
(4,254–5,368)
(4,835–6,160)
Prince Edward Island
279
(264–294)
4,612
(4,208–5,017)
Nova Scotia
1211 South Shore
1212 South West Nova
1223 Annapolis Valley
1234 Colchester East Hants
1258 Cape Breton
1269 Capital
289
265
287
271
292
366
270
(283–294)
(243–286)
(265–310)
(252–290)
(271–314)
(348–384)
(261–280)
4,772
4,825
4,619
4,744
4,922
6,532
4,182
(4,610–4,933)
(4,086–5,563)
(3,990–5,248)
(4,170–5,319)
(4,336–5,508)
(5,972–7,092)
(3,969–4,395)
New Brunswick
1301 Zone 1 (Moncton area)
1302 Zone 2 (Saint John area)
1303 Zone 3 (Fredericton area)
1306 Zone 6 (Bathurst area)
279
254
302
294
227
(273–286)
(241–266)
(288–316)
(279–308)
(209–245)
4,850
4,617
4,897
4,925
3,978
(4,661–5,040)
(4,254–4,979)
(4,522–5,272)
(4,535–5,315)
(3,434–4,522)
Quebec
2401 Bas-Saint-Laurent
2402 Saguenay–Lac-Saint-Jean
2403 Capitale-Nationale
2404 Mauricie et Centre-du-Québec
2405 Estrie
2406 Montréal
2407 Outaouais
2408 Abitibi-Témiscamingue
2409 Côte-Nord
2411 Gaspésie–Îles-de-la-Madeleine
2412 Chaudière-Appalaches
2413 Laval
2414 Lanaudière
2415 Laurentides
2416 Montérégie
257
252
268
245
280
244
253
294
280
309
329
233
222
267
268
249
(255–259)
(240–264)
(257–278)
(239–251)
(272–288)
(234–254)
(249–257)
(284–304)
(265–295)
(289–329)
(309–349)
(224–241)
(214–230)
(259–276)
(260–275)
(244–254)
4,382
4,773
4,855
4,101
5,184
4,428
4,162
4,455
4,826
5,476
6,379
4,203
3,783
4,352
4,534
4,143
(4,327–4,436)
(4,385–5,161)
(4,533–5,178)
(3,919–4,283)
(4,930–5,439)
(4,143–4,713)
(4,059–4,264)
(4,221–4,689)
(4,417–5,235)
(4,911–6,040)
(5,687–7,071)
(3,960–4,445)
(3,550–4,016)
(4,129–4,575)
(4,323–4,745)
(4,020–4,265)
Ontario
3501 Erie St. Clair
3502 South West
3503 Waterloo Wellington
3504 Hamilton Niagara Haldimand Brant
3505 Central West
3506 Mississauga Halton
3507 Toronto Central
3508 Central
3509 Central East
3510 South East
3511 Champlain
3512 North Simcoe Muskoka
3513 North East
3514 North West
246
274
260
224
264
201
186
223
176
225
283
232
263
309
330
(244–247)
(267–281)
(254–266)
(218–231)
(259–268)
(195–207)
(181–191)
(219–228)
(172–180)
(221–230)
(275–291)
(228–237)
(254–271)
(302–317)
(317–343)
4,182
4,530
4,474
3,739
4,421
3,683
3,057
3,819
3,017
3,908
4,925
3,822
4,451
5,445
6,829
(4,141–4,224)
(4,347–4,713)
(4,313–4,635)
(3,578–3,900)
(4,293–4,549)
(3,524–3,843)
(2,940–3,174)
(3,692–3,946)
(2,916–3,117)
(3,788–4,028)
(4,681–5,170)
(3,693–3,950)
(4,217–4,685)
(5,206–5,683)
(6,415–7,244)
Manitoba
4610 Winnipeg
4615 Brandon
4625 South Eastman
4630 Interlake
4640 Central
4645 Assiniboine
310
293
299
231
333
283
305
(304–316)
(286–301)
(271–327)
(208–254)
(311–355)
(264–302)
(282–328)
5,799
5,232
4,795
3,640
5,966
5,475
5,903
(5,637–5,961)
(5,029–5,434)
(4,131–5,460)
(3,124–4,156)
(5,283–6,650)
(4,943–6,007)
(5,172–6,635)
50
Health Status
Premature Mortality
2006 –2008
Map
Code
Age-Standardized Mortality
Rate per 100,000
95% CI
Age-Standardized PYLL†
per 100,000
95% CI
Saskatchewan
4701 Sun Country
4702 Five Hills
4704 Regina
4705 Sunrise
4706 Saskatoon
4709 Prince Albert
4710 Prairie North
305
274
283
291
308
279
342
365
(299–312)
(249–299)
(257–309)
(278–303)
(282–333)
(268–291)
(318–366)
(338–392)
5,931
4,998
5,139
5,480
5,632
5,055
7,266
7,724
(5,750–6,113)
(4,276–5,720)
(4,403–5,876)
(5,129–5,830)
(4,830–6,434)
(4,759–5,351)
(6,507–8,025)
(6,936–8,512)
Alberta
4831 South Zone
4832 Calgary Zone
4833 Central Zone
4834 Edmonton Zone
4835 North Zone
268
280
221
298
258
318
(265–271)
(268–291)
(216–226)
(288–307)
(252–264)
(307–328)
4,990
5,470
3,903
5,624
4,685
6,103
(4,906–5,074)
(5,147–5,793)
(3,782–4,025)
(5,366–5,883)
(4,539–4,830)
(5,835–6,372)
British
5911
5912
5913
5914
5921
5922
5923
5931
5932
5933
5941
5942
5943
5951
5952
5953
244
303
296
253
303
278
216
229
155
218
209
228
278
279
344
335
343
(242–247)
(281–324)
(275–317)
(244–262)
(290–316)
(267–290)
(209–223)
(222–236)
(145–165)
(211–224)
(200–219)
(220–237)
(267–289)
(262–295)
(319–369)
(318–352)
(315–370)
4,411
5,863
5,410
4,731
5,936
5,001
3,531
4,092
2,707
3,985
3,736
4,208
5,568
5,128
6,283
5,801
6,487
(4,337–4,485)
(5,173–6,553)
(4,763–6,057)
(4,438–5,024)
(5,526–6,346)
(4,698–5,303)
(3,360–3,702)
(3,915–4,269)
(2,411–3,003)
(3,801–4,170)
(3,443–4,028)
(3,947–4,469)
(5,179–5,957)
(4,617–5,638)
(5,612–6,954)
(5,352–6,251)
(5,785–7,188)
Yukon
367
(326–409)
6,745
(5,687–7,802)
Health Region
Columbia
East Kootenay
Kootenay Boundary
Okanagan
Thompson/Cariboo/Shuswap
Fraser East
Fraser North
Fraser South
Richmond
Vancouver
North Shore
South Vancouver Island
Central Vancouver Island
North Vancouver Island
Northwest
Northern Interior
Northeast
Northwest Territories
403
(358–448)
7,523
(6,595–8,450)
Nunavut
603
(526–680)
12,371
(10,974–13,769)
Canada
259
(258–259)
4,533
(4,506–4,560)
† Potential years of life lost.
Premature mortality
Premature deaths are those of individuals who are younger than age 75. Expressed as the age-standardized mortality rate and potential
years of life lost (PYLL) per 100,000 population. PYLL is the number of years of potential life not lived when a person dies before age 75.
Premature mortality is an overall indicator of population health that reflects deaths at younger ages. It can be used to guide efforts on health
promotion and disease prevention.
Note: Rates are based on three years of pooled data.
Source: Vital Statistics—Death Database, Statistics Canada.
51
Health Indicators 2012
Life Expectancy at Birth (Years)
2006 –2008
Male
Female
N.L.
P.E.I.
N.S.
N.B.
Que.
Ont.
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T.
Nun.
76.2
77.5
77.4
77.6
78.6
79.0
76.9
76.9
78.3
79.2
80.9
82.9
82.3
82.7
83.3
83.4
82.0
82.1
83.0
83.6
78.5
80.2
79.9
80.2
81.0
81.3
79.5
79.5
80.6
81.4
Both
72.5
78.5
75.2
Canada
78.5
83.1
80.9
Perinatal Mortality
2008
Infant Mortality
2008
Rate per 1,000 Total Births
Rate per 1,000 Live Births
6.9
3.4
5.6
4.3
5.3
6.5
9.0
6.8
7.0
4.8
8.0
13.8
8.7
5.1
2.0
3.5
3.2
4.3
5.3
6.5
6.2
6.2
3.7
5.4
9.7
16.1
6.2
5.1
Cancer Incidence, 2009
All Cancers
N.L.
P.E.I.
N.S.
N.B.
Que.
Ont.
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T.
Nun.
Canada
Bronchus and Lung
95% CI
Rate
95% CI
Rate
570.7
570.5
570.9
586.4
..
(549.9–591.5)
(531.1–609.9)
(555.6–586.1)
(569.1–603.7)
.. ..
76.4
96.4
87.5
91.4
..
(68.8–84.0)
(80.2–112.6)
(81.5–93.5)
(84.6–98.3)
.. ..
57.9
49.6
49.8
46.6
(51.2–64.5)
(38.0–61.2)
(45.3–54.3)
(41.7–51.5)
496.6
493.7
495.7
399.8
484.1
383.3
293.1
167.7
..
(492.7–500.4)
(481.2–506.2)
(482.1–509.3)
(393.3–406.2)
(477.7–490.6)
(317.2–449.5)
(242.3–343.9)
(123.0–212.5)
.. ..
60.3
69.0
64.3
49.6
62.2
71.3
32.1
49.7
..
(58.9–61.6)
(64.3–73.6)
(59.4–69.2)
(47.3–51.8)
(59.9–64.5)
(45.7–106.1)
(17.5–53.8)
(28.4–80.7)
.. ..
40.9
44.9
41.9
29.6
37.7
23.8
29.8
18.6
..
(39.8–42.0)
(41.1–48.6)
(37.9–45.8)
(27.9–31.4)
(35.9–39.5)
(10.3–46.8)
(15.8–50.9)
(6.8–40.6)
.. ..
Breast
Rate
N.L.
P.E.I.
N.S.
N.B.
Que.
Ont.
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T.
Nun.
Canada
52
Colon Excluding Rectum
Rate
..
Cervix Uteri
95% CI
95% CI
.. ..
Prostate
Rate
95% CI
Rate
95% CI
*
*
*
*
..
**
**
**
**
.. ..
5.9
4.3
4.0
3.1
..
(4.0–8.4)
(1.6–9.3)
(2.9–5.6)
(1.9–4.6)
.. ..
97.8
101.3
76.5
94.6
(89.2–106.4)
(84.7–118.0)
(70.9–82.0)
(87.7–101.6)
69.5
*
*
54.0
65.3
*
*
*
..
(68.1–70.9)
**
**
(51.7–56.4)
(62.9–67.7)
**
**
**
.. ..
4.7
4.2
4.0
4.4
3.9
*
*
*
..
(4.4–5.1)
(3.0–5.3)
(2.9–5.4)
(3.8–5.1)
(3.3–4.4)
**
**
**
.. ..
68.7
58.9
70.3
59.3
71.2
59.4
*
*
..
(67.3–70.1)
(54.6–63.2)
(65.1–75.4)
(56.8–61.7)
(68.7–73.7)
(36.3–91.8)
**
**
.. ..
..
.. ..
Health Status
Life expectancy at birth
Life expectancy is the number of years a person would be expected to live starting from birth and is calculated
on the basis of the mortality statistics for a given observation period. A widely used indicator of the health of a
population, life expectancy measures quantity rather than quality of life.
Note: Rates are based on three years of pooled data.
Sources: Vital Statistics—Death Database and Demography Division (population estimates), Statistics Canada.
Perinatal mortality
Rate of stillbirths and early neonatal deaths (deaths in the first week of life) per 1,000 total births (including
stillbirths). Stillbirths are defined as death at gestational age of 28 weeks or more. This indicator reflects
standards of obstetric and pediatric care, as well as the effectiveness of public health initiatives.
Sources: Vital Statistics—Birth, Death and Stillbirth Databases, Statistics Canada.
Infant mortality
Infants who die in the first year of life, expressed as a rate per 1,000 live births. A long-established measure,
not only of child health, but also of the well-being of a society. This indicator reflects the level of mortality, health
status and health care of a population as well as the effectiveness of preventive care and the attention paid to
maternal and child health.
Sources: Vital Statistics—Birth and Death Databases, Statistics Canada.
Cancer incidence
Rate of new primary sites of cancer (malignant neoplasms) per 100,000 population, for all cancers and selected
specific sites.
Sources: Vital Statistics, Cancer Database, Canadian Cancer Registry and Demography Division (population estimates),
Statistics Canada.
53
Health Indicators 2012
Self-Reported Conditions
Youth Body Mass Index (Age 12–17)
(25 or Greater)
2010
%
Adult Body Mass Index (Age 18+)
(25 or Greater)
2010
95% CI
%
95% CI
N.L.
P.E.I.
N.S.
N.B.
Que.
Ont.
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T.
Nun.
33.2
24.0 ▼
23.4 ▼
20.1 ▼
20.5
20.1
21.7
22.9
18.6
16.4
35.0 ▼
28.4 ▼
*
(24.2–42.2)
(11.5–36.6)
(15.4–31.5)
(13.1–27.1)
(16.1–24.9)
(17.2–22.9)
(14.7–28.7)
(16.3–29.4)
(13.7–23.5)
(12.1–20.7)
(18.4–51.5)
(16.7–40.2)
**
63.2
56.6
61.1
62.8
51.8
52.6
60.7
58.9
51.6
44.4
51.8
54.2
60.1
(59.9–66.5)
(52.2–61.1)
(58.0–64.1)
(59.9–65.7)
(50.3–53.3)
(51.3–54.0)
(57.6–63.7)
(56.2–61.6)
(49.5–53.7)
(42.5–46.3)
(47.0–56.7)
(47.9–60.6)
(49.4–70.7)
Canada
20.0
(18.2–21.9)
52.3
(51.6–53.0)
Diabetes (Age 12+)
2010
%
N.L.
P.E.I.
N.S.
N.B.
Que.
Ont.
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T.
Nun.
8.3
8.5
8.3
8.0
5.5
7.2
6.1
7.2
5.4
5.2
5.5 ▼
4.0 ▼
*
Canada
6.4
High Blood Pressure (Age 12+)
2010
95% CI
(6.9–9.7)
(6.0–10.9)
(7.0–9.6)
(6.7–9.4)
(5.0–6.0)
(6.6–7.9)
(4.9–7.3)
(5.8–8.5)
(4.5–6.3)
(4.5–6.0)
(3.0–7.9)
(1.9–6.1)
**
(6.1–6.7)
Asthma (Age 12+)
2010
N.L.
P.E.I.
N.S.
N.B.
Que.
Ont.
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T.
Nun.
Canada
54
%
95% CI
24.2
18.4
20.5
22.0
17.1
17.6
16.9
18.3
15.1
14.9
11.3
11.9
9.0 ▼
(21.9–26.4)
(15.4–21.3)
(18.7–22.2)
(19.9–24.0)
(16.1–18.2)
(16.7–18.4)
(15.0–18.9)
(16.5–20.0)
(13.8–16.4)
(13.8–16.1)
(7.8–14.8)
(9.1–14.8)
(4.8–13.1)
17.1
(16.7–17.6)
Chronic Obstructive Pulmonary Disease (Age 35+)
2010
%
95% CI
8.0
10.1
9.4
8.6
8.6
8.3
9.8
8.2
9.5
7.5
10.5
6.8
*
(6.4–9.7)
(7.4–12.8)
(7.8–11.0)
(7.1–10.1)
(7.8–9.4)
(7.7–8.9)
(8.2–11.5)
(6.8–9.5)
(8.2–10.7)
(6.5–8.4)
(7.1–13.9)
(4.8–8.8)
**
8.5
(8.1–8.8)
%
95% CI
5.2
4.3 ▼
5.6
5.6
4.3
4.4
4.9
4.7
3.4
3.7
4.7 ▼
*
*
(3.6–6.7)
(2.8–5.7)
(4.5–6.8)
(4.2–6.9)
(3.6–4.9)
(4.0–4.9)
(3.5–6.4)
(3.2–6.1)
(2.7–4.1)
(2.9–4.4)
(2.4–7.0)
**
**
4.3
(4.0–4.6)
Health Status
The data presented here represents a sample of a wider range of the health status indicators
that are available in the Health Indicators e-publication.
www.cihi.ca or www.statcan.gc.ca
Youth body mass index
Proportion of household population age 12 to 17 with a body mass index (BMI) of 25 or greater. According to the
World Health Organization and Health Canada guidelines, a BMI of 25 or greater is classified as overweight or
obese, which is associated with increased health risk. BMI is calculated from weight and height collected from
respondents by dividing body weight (in kilograms) by height (in metres) squared.
Source: Canadian Community Health Survey, Statistics Canada.
Adult body mass index
Proportion of household population age 18 and older with a body mass index (BMI) of 25 or greater. According to
the World Health Organization and Health Canada guidelines, a BMI of 25 or greater is classified as overweight
or obese, which is associated with increased health risk. BMI is calculated from weight and height collected from
respondents by dividing body weight (in kilograms) by height (in metres) squared.
Source: Canadian Community Health Survey, Statistics Canada.
Diabetes
Proportion of household population age 12 and older that reported being diagnosed by a health professional as
having diabetes. This includes females 15 and older who reported being diagnosed with gestational diabetes.
Source: Canadian Community Health Survey, Statistics Canada.
High blood pressure
Proportion of household population age 12 and older that reported being diagnosed by a health professional as
having high blood pressure.
Source: Canadian Community Health Survey, Statistics Canada.
Asthma
Proportion of household population age 12 and older that reported being diagnosed by a health professional as
having asthma.
Source: Canadian Community Health Survey, Statistics Canada.
Chronic obstructive pulmonary disease
Proportion of household population age 35 and older that reported being diagnosed by a health professional with
chronic bronchitis, emphysema or chronic obstructive pulmonary disease (COPD).
Source: Canadian Community Health Survey, Statistics Canada.
55
Health Indicators 2012
Injury Hospitalization
2010 –2011
Map
Code Health Region
Newfoundland and Labrador
1011 Eastern
1012 Central
1013 Western
Age-Standardized
Rate per 100,000
95% CI
525
485
419
631
(505–544)
(461–510)
(375–464)
(574–689)
Prince Edward Island
603
(564–642)
Nova
1211
1212
1223
1234
1258
1269
492
565
507
507
516
589
425
(478–505)
(505–624)
(453–561)
(462–553)
(465–567)
(545–632)
(406–444)
New Brunswick
1301 Zone 1 (Moncton area)
1302 Zone 2 (Saint John area)
1303 Zone 3 (Fredericton area)
1306 Zone 6 (Bathurst area)
583
457
497
640
592
(566–600)
(429–486)
(465–529)
(604–677)
(535–649)
Quebec
2401 Bas-Saint-Laurent
2402 Saguenay–Lac-Saint-Jean
2403 Capitale-Nationale
2404 Mauricie et Centre-du-Québec
2405 Estrie
2406 Montréal
2407 Outaouais
2408 Abitibi-Témiscamingue
2409 Côte-Nord
2411 Gaspésie–Îles-de-la-Madeleine
2412 Chaudière-Appalaches
2413 Laval
2414 Lanaudière
2415 Laurentides
2416 Montérégie
514
659
688
512
634
630
398
445
793
609
822
546
424
467
567
528
(509–519)
(625–694)
(657–718)
(496–528)
(612–656)
(603–657)
(390–406)
(424–466)
(748–839)
(560–658)
(763–881)
(524–568)
(405–443)
(447–486)
(547–586)
(516–539)
Ontario
3501 Erie St. Clair
3502 South West
3503 Waterloo Wellington
3504 Hamilton Niagara Haldimand Brant
3505 Central West
3506 Mississauga Halton
3507 Toronto Central
3508 Central
3509 Central East
3510 South East
3511 Champlain
3512 North Simcoe Muskoka
3513 North East
3514 North West
407
422
512
392
495
334
326
357
306
339
424
386
478
637
801
(403–410)
(407–437)
(499–526)
(379–406)
(484–506)
(322–347)
(316–336)
(347–367)
(298–314)
(330–347)
(407–441)
(376–397)
(459–497)
(617–657)
(765–836)
Manitoba
4610 Winnipeg
4615 Brandon
4625 South Eastman
4630 Interlake
4640 Central
4645 Assiniboine
621
457
602
618
681
726
736
(607–634)
(442–472)
(539–666)
(558–677)
(623–740)
(676–775)
(673–799)
56
Scotia
South Shore
South West Nova
Annapolis Valley
Colchester East Hants
Cape Breton
Capital
Health Status
Injury Hospitalization
2010 –2011
Map
Code Health Region
Age-Standardized
Rate per 100,000
95% CI
Saskatchewan
4701 Sun Country
4702 Five Hills
4704 Regina
4705 Sunrise
4706 Saskatoon
4709 Prince Albert
4710 Prairie North
772
1,061
815
772
1,002
560
721
868
(756–788)
(975–1,146)
(739–891)
(739–805)
(919–1,085)
(535–585)
(661–781)
(799–936)
Alberta
4831 South Zone
4832 Calgary Zone
4833 Central Zone
4834 Edmonton Zone
4835 North Zone
698
825
557
875
627
1,048
(690–707)
(792–858)
(544–569)
(848–901)
(613–641)
(1,016–1,079)
British Columbia
5911 East Kootenay
5912 Kootenay Boundary
5913 Okanagan
5914 Thompson/Cariboo/Shuswap
5921 Fraser East
5922 Fraser North
5923 Fraser South
5931 Richmond
5932 Vancouver
5933 North Shore
5941 South Vancouver Island
5942 Central Vancouver Island
5943 North Vancouver Island
5951 Northwest
5952 Northern Interior
5953 Northeast
554
779
705
645
684
634
536
530
340
397
527
515
618
676
1,096
812
667
(547–560)
(718–839)
(645–764)
(619–672)
(650–718)
(606–661)
(519–554)
(514–546)
(316–365)
(383–412)
(501–553)
(493–538)
(588–648)
(629–723)
(1,018–1,175)
(765–859)
(604–730)
Yukon
1,156
(1,034–1,278)
Northwest Territories
1,222
(1,104–1,340)
Nunavut
1,042
(891–1,193)
514
(512–516)
Canada
Injury hospitalization
Age-standardized rate of acute care hospitalization due to injury resulting from the transfer of energy (excludes poisoning and other
non-traumatic injuries), per 100,000 population. This indicator contributes to an understanding of the adequacy and effectiveness of
injury prevention efforts, including public education, product development and use, community and road design, and prevention and
treatment resources.
Sources: National Trauma Registry, Canadian Institute for Health Information; Fichier des hospitalisations MED-ÉCHO, ministère de la Santé et des
Services sociaux du Québec.
57
Health Indicators 2012
Hospitalized Acute Myocardial Infarction Event
2010 –2011
Map
Code Health Region
95% CI
Age-Standardized
Rate per 100,000
95% CI
320
323
364
267
(304–335)
(302–343)
(326–401)
(232–302)
146
157
133
133
(136–157)
(143–172)
(110–155)
(109–157)
Prince Edward Island
312
(283–340)
128
(110–146)
Nova
1211
1212
1223
1234
1258
1269
260
334
309
273
317
338
187
(250–270)
(292–377)
(267–351)
(239–307)
(276–358)
(306–369)
(173–200)
122
175
128
115
150
126
113
(115–129)
(145–204)
(102–154)
(93–138)
(123–178)
(108–145)
(102–124)
New Brunswick
1301 Zone 1 (Moncton area)
1302 Zone 2 (Saint John area)
1303 Zone 3 (Fredericton area)
1306 Zone 6 (Bathurst area)
266
255
234
339
228
(254–277)
(233–277)
(211–257)
(311–367)
(197–259)
Quebec
2401 Bas-Saint-Laurent
2402 Saguenay–Lac-Saint-Jean
2403 Capitale-Nationale
2404 Mauricie et Centre-du-Québec
2405 Estrie
2406 Montréal
2407 Outaouais
2408 Abitibi-Témiscamingue
2409 Côte-Nord
2411 Gaspésie–Îles-de-la-Madeleine
2412 Chaudière-Appalaches
2413 Laval
2414 Lanaudière
2415 Laurentides
2416 Montérégie
214
226
217
207
252
285
194
217
270
238
378
198
165
273
186
210
(211–217)
(206–245)
(200–234)
(197–218)
(239–266)
(267–303)
(188–200)
(201–233)
(243–297)
(206–270)
(342–415)
(184–211)
(152–177)
(257–289)
(174–197)
(202–217)
133
122
123
127
125
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
(125–141)
(107–137)
(107–139)
(110–144)
(102–148)
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
Ontario
3501 Erie St. Clair
3502 South West
3503 Waterloo Wellington
3504 Hamilton Niagara Haldimand Brant
3505 Central West
3506 Mississauga Halton
3507 Toronto Central
3508 Central
3509 Central East
3510 South East
3511 Champlain
3512 North Simcoe Muskoka
3513 North East
3514 North West
207
250
210
200
245
200
170
154
154
191
218
196
274
330
327
(205–210)
(237–262)
(201–220)
(189–211)
(237–253)
(190–211)
(162–178)
(147–161)
(148–161)
(183–198)
(205–230)
(188–204)
(259–289)
(316–344)
(304–351)
125
142
126
124
127
139
125
121
119
124
127
105
120
144
163
(123–127)
(133–151)
(119–133)
(115–132)
(122–133)
(129–148)
(118–132)
(114–128)
(113–124)
(118–130)
(118–137)
(99–110)
(110–130)
(135–154)
(146–179)
Manitoba
4610 Winnipeg
4615 Brandon
4625 South Eastman
4630 Interlake
4640 Central
4645 Assiniboine
248
225
144
266
305
289
209
(239–257)
(214–237)
(110–179)
(221–311)
(267–342)
(254–323)
(175–242)
126
123
107
162
106
109
127
(119–133)
(115–132)
(78–135)
(127–197)
(83–128)
(88–129)
(101–152)
Newfoundland and Labrador
1011 Eastern
1012 Central
1013 Western
58
Scotia
South Shore
South West Nova
Annapolis Valley
Colchester East Hants
Cape Breton
Capital
Age-Standardized
Rate per 100,000
Hospitalized Stroke Event
2010 –2011
Health Status
Hospitalized Acute Myocardial Infarction Event
2010 –2011
Map
Code Health Region
Age-Standardized
Rate per 100,000
Hospitalized Stroke Event
2010 –2011
95% CI
Age-Standardized
Rate per 100,000
95% CI
Saskatchewan
4701 Sun Country
4702 Five Hills
4704 Regina
4705 Sunrise
4706 Saskatoon
4709 Prince Albert
4710 Prairie North
209
158
244
189
182
180
252
283
(200–218)
(124–192)
(204–285)
(171–206)
(149–216)
(164–196)
(216–287)
(239–328)
128
112
123
127
144
125
140
141
(121–135)
(83–140)
(93–152)
(112–142)
(113–175)
(112–138)
(111–168)
(111–171)
Alberta
4831 South Zone
4832 Calgary Zone
4833 Central Zone
4834 Edmonton Zone
4835 North Zone
196
225
159
249
186
259
(191–201)
(207–244)
(151–167)
(233–265)
(177–195)
(240–277)
119
112
113
131
118
137
(115–123)
(99–125)
(106–120)
(119–142)
(111–125)
(124–151)
British Columbia
5911 East Kootenay
5912 Kootenay Boundary
5913 Okanagan
5914 Thompson/Cariboo/Shuswap
5921 Fraser East
5922 Fraser North
5923 Fraser South
5931 Richmond
5932 Vancouver
5933 North Shore
5941 South Vancouver Island
5942 Central Vancouver Island
5943 North Vancouver Island
5951 Northwest
5952 Northern Interior
5953 Northeast
163
246
265
183
210
197
134
158
125
136
159
118
187
184
212
204
209
(159–167)
(213–280)
(232–297)
(170–196)
(191–228)
(180–214)
(124–144)
(148–167)
(109–142)
(127–146)
(145–173)
(108–129)
(172–202)
(161–207)
(175–248)
(178–229)
(167–252)
119
107
135
129
122
145
138
117
109
112
113
101
114
125
133
111
117
(116–122)
(85–130)
(112–158)
(119–140)
(108–137)
(131–160)
(127–148)
(109–125)
(94–125)
(103–120)
(101–125)
(91–111)
(102–126)
(106–144)
(104–162)
(91–131)
(84–150)
Yukon
213
(149–278)
126
(76–176)
Northwest Territories
299
(219–380)
253
(177–328)
Nunavut
200
(86–314)
184
(70–299)
Canada
209
(207–210)
124
(123–125)
Hospitalized acute myocardial infarction event
Age-standardized rate of new acute myocardial infarction (AMI) events admitted to an acute care hospital, per 100,000 population age
20 and older. New event is defined as a first-ever hospitalization for an AMI or a recurrent hospitalized AMI occurring more than 28 days
after the admission for the previous event in the reference period. AMI is one of the leading causes of morbidity and death. This indicator
is important for planning and evaluating preventive strategies, allocating health resources and estimating costs.
Sources: Discharge Abstract Database, Canadian Institute for Health Information; Fichier des hospitalisations MED-ÉCHO, ministère de la Santé et des
Services sociaux du Québec.
Hospitalized stroke event
Age-standardized rate of new stroke events admitted to an acute care hospital, per 100,000 population age 20 and older. New event is
defined as a first-ever hospitalization for stroke or a recurrent hospitalized stroke occurring more than 28 days after the admission for the
previous event in the reference period. Stroke is one of the leading causes of long-term disability and death. This indicator is important for
planning and evaluating preventive strategies, allocating health resources and estimating costs.
Note: Rates for Quebec are not available due to differences in data collection; the Canada rate does not include Quebec.
Source: Discharge Abstract Database, Canadian Institute for Health Information.
59
Health Indicators 2012
Hospitalized Acute Myocardial Infarction Event, 2010 –2011
Q1
95% CI
N.L.
P.E.I.
N.S.
N.B.
Que.
Ont.
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T.
Nun.
Canada
Neighbourhood Income Quintile †
Q2
Q3
Q4
95% CI
95% CI
95% CI
Q5
95% CI
364
312
275
313
295
(328–400)
(278–346)
(243–306)
(279–348)
(260–331)
351
326
369
392
259
(276–427)
(255–396)
(295–443)
(315–470)
(201–316)
282
288
273
250
228
(258–306)
(264–312)
(250–297)
(228–272)
(205–250)
304
283
285
242
247
(276–333)
(257–310)
(257–313)
(218–267)
(220–275)
248
227
213
218
188
(240–255)
(220–234)
(206–221)
(211–226)
(181–195)
254
224
222
198
178
(247–260)
(218–230)
(216–228)
(192–203)
(173–183)
315
274
232
243
220
(288–342)
(252–296)
(212–251)
(222–263)
(200–239)
278
215
182
205
178
(252–304)
(194–235)
(163–201)
(185–226)
(158–197)
222
201
223
194
171
(210–234)
(190–213)
(210–236)
(182–206)
(159–182)
Disparity Rate Ratio
95% CI
1.23
(1.05–1.44)
1.36
(1.00–1.85)
1.24
(1.09–1.41)
1.23
(1.06–1.42)
1.32
(1.25–1.38)
1.43
(1.37–1.48)
1.43
(1.27–1.62)
1.56
(1.35–1.81)
1.30
(1.19–1.42)
192
178
177
158
139
(183–202)
(169–186)
(168–186)
(150–167)
(131–147)
(1.28–1.49)
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
247
222
217
203
180
(243–251)
(219–226)
(213–220)
(200–207)
(177–184)
1.38
1.37
(1.34–1.40)
Potential Rate Reduction (%)
95% CI
5.3%
(-5.1%–14.9%)
23.7%
(6.4%–38.2%)
14.1%
(6.0%–21.5%)
9.4%
(-0.1%–18.1%)
14.3%
(11.3%–17.3%)
17.2%
(15.0%–19.4%)
14.1%
(6.9%–20.8%)
15.7%
(6.9%–23.8%)
15.6%
(10.3%–20.6%)
17.6%
(13.2%–21.8%)
*
*
*
15.8%
(14.3%–17.2%)
Injury Hospitalization, 2010 –2011
Q1
95% CI
N.L.
P.E.I.
N.S.
N.B.
Que.
Ont.
Man.
524
519
498
581
512
(473–565)
(452–543)
(531–630)
(468–557)
773
620
701
616
559
(665–881)
(525–715)
(601–801)
(522–710)
(470–648)
563
531
491
492
473
(529–596)
(498–563)
(459–522)
(460–524)
(441–506)
667
640
613
587
541
(625–709)
(598–682)
(572–653)
(547–628)
(503–579)
576
549
526
538
480
(564–587)
(538–560)
(515–537)
(526–550)
(468–491)
481
414
418
407
397
(473–489)
(407–422)
(410–426)
(399–414)
(390–405)
1,079
1,205
(1,155–1,254)
Alta.
B.C.
Y.T.
N.W.T.
Nun.
Canada
601
571
494
532
(570–631)
(541–601)
(467–522)
(501–563)
774
700
675
707
(736–812)
(664–736)
(639–711)
(668–746)
869
701
713
704
679
(847–890)
(682–720)
(693–732)
(684–724)
(659–700)
636
582
592
591
554
(620–652)
(566–598)
(576–607)
(575–608)
(537–571)
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
618
528
521
515
487
(612–623)
(523–534)
(516–526)
(509–520)
(482–492)
† Age-standardized rates per 100,000 population.
60
Q5
95% CI
(479–570)
(1,036–1,122)
Sask.
Neighbourhood Income Quintile †
Q2
Q3
Q4
95% CI
95% CI
95% CI
Disparity Rate Ratio
95% CI
1.02
(0.91–1.16)
1.38
(1.12–1.71)
1.19
(1.09–1.30)
1.23
(1.12–1.35)
1.20
(1.16–1.24)
1.21
(1.18–1.24)
2.03
(1.89–2.18)
1.70
(1.59–1.82)
1.28
(1.23–1.33)
1.15
(1.10–1.19)
*
*
*
1.27
(1.25–1.29)
Potential Rate Reduction (%)
95% CI
2.7%
(-5.1%–10.0%)
14.3%
(1.2%–26.0%)
7.2%
(1.3%–12.7%)
11.3%
(5.5%–16.8%)
10.2%
(8.3%–12.1%)
6.2%
(4.6%–7.8%)
18.9%
(14.6%–23.1%)
12.9%
(8.5%–17.2%)
7.4%
(4.9%–9.9%)
6.3%
(3.7%–8.8%)
*
*
*
8.8%
(7.9%–9.7%)
Equity
Neighbourhood income quintile
Small geographic areas divided into five roughly equal population groups. Quintile 1 refers to the least affluent
neighbourhoods, while quintile 5 refers to the most affluent. The quintiles were constructed according to the
methods developed at Statistics Canada.
Disparity rate ratio (RR)
Ratio of a health indicator rate for the least affluent neighbourhood income quintile (Q1) to the rate for the most
affluent neighbourhood income quintile (Q5). It provides a summary measure of the magnitude of the socioeconomic disparity for a health indicator in a jurisdiction. It should be evaluated together with other measures,
such as the indicator rate for each neighbourhood income quintile as well as the potential rate reduction. The
95% confidence interval (CI) is provided to assist interpretation. When the 95% CI does not contain a value of 1,
RR indicates a statistically significant disparity between Q1 and Q5 rates within the jurisdiction, as indicated by
the symbol.
Potential rate reduction (PRR)
Reduction in a health indicator rate that would occur in the hypothetical scenario that each neighbourhood
income group experienced the rate of the most affluent neighbourhood income quintile (Q5), expressed as a
percentage. This measure is based on the concept of the excess morbidity or mortality that could be prevented
and provides a summary measure of the overall effect of socio-economic disparities on a health indicator. It
should be evaluated together with other measures, such as the indicator rate for each neighbourhood income
quintile as well as the disparity rate ratio. The 95% CI is provided to assist interpretation. When the 95% CI does
not contain a value of 0, PRR indicates a statistically significant potential reduction in the overall indicator rate
within the jurisdiction, as indicated by the symbol.
61
Health Indicators 2012
Self-Reported Health Behaviours
Smoking (Age 12+)
2010
Heavy Drinking (Age 12+)
2010
%
95% CI
N.L.
P.E.I.
N.S.
N.B.
Que.
Ont.
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T.
Nun.
23.0
23.6
23.2
22.5
23.3
19.3
18.8
22.8
22.7
17.4
27.9
41.7
54.4
(20.4–25.5)
(19.8–27.3)
(20.6–25.8)
(20.4–24.6)
(22.1–24.6)
(18.4–20.3)
(16.5–21.0)
(20.1–25.5)
(20.9–24.4)
(16.0–18.8)
(23.8–31.9)
(36.0–47.4)
(48.0–60.8)
23.8
18.1
20.2
20.6
17.7
16.1
19.0
18.9
19.5
15.7
26.3
35.5
12.9 ▼
(21.4–26.1)
(14.7–21.4)
(17.8–22.6)
(18.5–22.8)
(16.7–18.8)
(15.3–16.9)
(16.8–21.1)
(16.4–21.3)
(17.8–21.2)
(14.4–17.1)
(21.8–30.7)
(30.8–40.3)
(7.6–18.1)
Canada
20.8
(20.2–21.3)
17.3
(16.9–17.8)
Fruit and Vegetable Consumption (Age 12+)
(5+ per Day)
2010
%
95% CI
Physical Activity During Leisure Time (Age 12+)
(Active/Moderately Active)
2010
%
95% CI
%
95% CI
N.L.
P.E.I.
N.S.
N.B.
Que.
Ont.
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T.
Nun.
28.6
35.4
34.9
37.5
50.4
42.8
34.6
37.9
40.7
42.3
52.5
26.9
22.8
(25.7–31.4)
(31.5–39.3)
(32.2–37.7)
(34.9–40.2)
(49.0–51.8)
(41.4–44.2)
(31.6–37.6)
(35.4–40.3)
(38.6–42.9)
(40.4–44.3)
(46.8–58.3)
(22.1–31.6)
(16.1–29.4)
47.8
50.2
53.4
52.0
49.7
50.4
53.8
50.5
55.9
58.3
61.7
50.5
46.1
(45.0–50.5)
(46.1–54.4)
(50.4–56.4)
(49.0–54.9)
(48.2–51.3)
(49.2–51.7)
(50.4–57.3)
(47.8–53.3)
(53.7–58.2)
(56.6–59.9)
(56.1–67.3)
(44.7–56.3)
(34.6–57.5)
Canada
43.3
(42.5–44.0)
52.1
(51.4–52.8)
Bicycle Helmet Use (Age 12+)
2010
Exposure to Second-Hand Smoke (Age 12+)
(At Home)
2010
%
95% CI
N.L.
P.E.I.
N.S.
N.B.
Que.
Ont.
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T.
Nun.
41.1
53.5
68.0
53.1
28.4
33.8
19.9
24.1
46.6
61.3
57.1
28.7
*
(33.7–48.5)
(45.6–61.4)
(62.2–73.7)
(48.2–58.1)
(26.4–30.4)
(32.0–35.6)
(16.3–23.5)
(20.3–27.9)
(43.2–50.0)
(58.3–64.3)
(47.5–66.7)
(22.7–34.7)
**
6.5
5.0 ▼
8.6
6.6
8.7
5.0
5.7
6.3
5.8
2.8
7.3 ▼
6.8 ▼
*
(4.7–8.3)
(3.1–6.9)
(6.6–10.7)
(5.1–8.1)
(7.8–9.6)
(4.5–5.6)
(4.2–7.3)
(4.8–7.8)
(4.6–7.0)
(2.2–3.4)
(4.8–9.8)
(3.2–10.4)
**
Canada
37.3
(36.3–38.3)
5.9
(5.5–6.2)
62
%
95% CI
Non-Medical Determinants of Health
The data presented here represents a sample of a wider range of the non-medical determinants
of health that are available in the Health Indicators e-publication.
www.cihi.ca or www.statcan.gc.ca
Smoking
Proportion of household population age 12 and older that reported being a current smoker on either a daily or
occasional basis.
Source: Canadian Community Health Survey, Statistics Canada.
Heavy drinking
Proportion of household population age 12 and older that reported drinking five or more drinks on at least one
occasion per month in the past 12 months.
Source: Canadian Community Health Survey, Statistics Canada.
Fruit and vegetable consumption
Proportion of household population age 12 and older that reported consuming fruits and vegetables five or more
times per day, on average.
Source: Canadian Community Health Survey, Statistics Canada.
Physical activity during leisure time
Proportion of household population age 12 and older that reported active or moderately active levels of physical
activity, based on their responses to questions about the frequency, duration and intensity of their participation in
leisure-time physical activity over the past three months.
Source: Canadian Community Health Survey, Statistics Canada.
Bicycle helmet use
Proportion of household population age 12 and older that reported always wearing a helmet when riding a bicycle
in the last 12 months.
Source: Canadian Community Health Survey, Statistics Canada.
Exposure to second-hand smoke at home
Proportion of non-smoking population age 12 and older that reported that at least one person smoked inside their
home every day or almost every day.
Source: Canadian Community Health Survey, Statistics Canada.
63
Health Indicators 2012
Potentially Avoidable Mortality
2006 –2008
Map
Code Health Region
Newfoundland and Labrador
1011 Eastern
1012 Central
1013 Western
Age-Standardized
Mortality Rate
per 100,000
95% CI
220
224
188
224
(213–227)
(215–234)
(174–203)
(206–242)
3,967
3,944
3,287
4,204
Age-Standardized
PYLL† per 100,000
95% CI
(3,745–4,190)
(3,656–4,232)
(2,814–3,759)
(3,608–4,799)
Prince Edward Island
201
(188–214)
3,468
(3,104–3,832)
Nova
1211
1212
1223
1234
1258
1269
208
189
212
195
216
266
191
(203–213)
(170–207)
(193–232)
(179–211)
(198–235)
(250–281)
(184–199)
3,586
3,577
3,518
3,427
3,813
4,893
3,130
(3,443–3,729)
(2,937–4,217)
(2,974–4,061)
(2,940–3,914)
(3,281–4,344)
(4,399–5,388)
(2,941–3,319)
New Brunswick
1301 Zone 1 (Moncton area)
1302 Zone 2 (Saint John area)
1303 Zone 3 (Fredericton area)
1306 Zone 6 (Bathurst area)
195
178
209
200
163
(190–201)
(167–188)
(197–221)
(188–212)
(148–178)
3,502
3,416
3,512
3,424
2,905
(3,339–3,665)
(3,097–3,734)
(3,191–3,833)
(3,097–3,751)
(2,433–3,377)
Quebec
2401 Bas-Saint-Laurent
2402 Saguenay–Lac-Saint-Jean
2403 Capitale-Nationale
2404 Mauricie et Centre-du-Québec
2405 Estrie
2406 Montréal
2407 Outaouais
2408 Abitibi-Témiscamingue
2409 Côte-Nord
2411 Gaspésie–Îles-de-la-Madeleine
2412 Chaudière-Appalaches
2413 Laval
2414 Lanaudière
2415 Laurentides
2416 Montérégie
188
187
191
174
205
177
184
216
216
235
246
169
162
197
197
181
(186–189)
(176–197)
(182–201)
(168–179)
(198–212)
(169–185)
(181–188)
(207–225)
(202–229)
(218–253)
(228–263)
(162–176)
(155–169)
(190–205)
(191–204)
(177–185)
3,375
3,805
3,674
3,147
4,009
3,394
3,164
3,348
3,888
4,398
4,940
3,305
2,944
3,436
3,500
3,160
(3,326–3,424)
(3,450–4,161)
(3,387–3,961)
(2,984–3,311)
(3,782–4,237)
(3,138–3,649)
(3,072–3,255)
(3,143–3,554)
(3,515–4,260)
(3,882–4,914)
(4,308–5,571)
(3,082–3,527)
(2,732–3,156)
(3,231–3,640)
(3,310–3,690)
(3,051–3,270)
Ontario
3501 Erie St. Clair
3502 South West
3503 Waterloo Wellington
3504 Hamilton Niagara Haldimand Brant
3505 Central West
3506 Mississauga Halton
3507 Toronto Central
3508 Central
3509 Central East
3510 South East
3511 Champlain
3512 North Simcoe Muskoka
3513 North East
3514 North West
177
198
186
160
190
146
131
164
124
163
203
165
192
230
248
(176–179)
(192–204)
(181–191)
(155–166)
(186–194)
(141–151)
(126–135)
(160–168)
(121–127)
(159–167)
(196–210)
(161–169)
(185–199)
(223–237)
(236–259)
3,159
3,351
3,342
2,772
3,325
2,846
2,288
2,942
2,269
2,957
3,673
2,812
3,430
4,188
5,415
(3,122–3,196)
(3,192–3,509)
(3,200–3,484)
(2,632–2,913)
(3,212–3,439)
(2,702–2,989)
(2,183–2,392)
(2,829–3,056)
(2,179–2,360)
(2,850–3,064)
(3,458–3,889)
(2,700–2,924)
(3,218–3,642)
(3,976–4,399)
(5,042–5,788)
Manitoba
4610 Winnipeg
4615 Brandon
4625 South Eastman
4630 Interlake
4640 Central
4645 Assiniboine
226
210
216
159
241
210
236
(221–231)
(204–216)
(192–240)
(140–178)
(222–260)
(194–227)
(215–256)
4,492
3,986
3,710
2,585
4,668
4,203
4,843
(4,346–4,637)
(3,805–4,168)
(3,114–4,307)
(2,145–3,025)
(4,050–5,285)
(3,731–4,675)
(4,171–5,515)
64
Scotia
South Shore
South West Nova
Annapolis Valley
Colchester East Hants
Cape Breton
Capital
Health System Performance
Potentially Avoidable Mortality
2006 –2008
Map
Code Health Region
Age-Standardized
Mortality Rate
per 100,000
95% CI
Saskatchewan
4701 Sun Country
4702 Five Hills
4704 Regina
4705 Sunrise
4706 Saskatoon
4709 Prince Albert
4710 Prairie North
222
197
196
208
222
198
268
272
(217–228)
(175–218)
(175–217)
(197–218)
(200–244)
(189–208)
(247–290)
(249–296)
4,552
3,836
3,635
4,023
4,462
3,810
5,940
6,177
(4,391–4,714)
(3,191–4,481)
(3,001–4,269)
(3,720–4,325)
(3,719–5,205)
(3,549–4,071)
(5,244–6,636)
(5,461–6,893)
Alberta
4831 South Zone
4832 Calgary Zone
4833 Central Zone
4834 Edmonton Zone
4835 North Zone
198
203
161
221
189
243
(195–201)
(194–213)
(157–166)
(213–229)
(184–194)
(234–253)
3,870
4,251
2,995
4,416
3,541
4,908
(3,795–3,945)
(3,961–4,540)
(2,887–3,104)
(4,183–4,650)
(3,414–3,668)
(4,665–5,150)
British Columbia
5911 East Kootenay
5912 Kootenay Boundary
5913 Okanagan
5914 Thompson/Cariboo/Shuswap
5921 Fraser East
5922 Fraser North
5923 Fraser South
5931 Richmond
5932 Vancouver
5933 North Shore
5941 South Vancouver Island
5942 Central Vancouver Island
5943 North Vancouver Island
5951 Northwest
5952 Northern Interior
5953 Northeast
172
214
205
172
213
199
153
164
113
157
147
156
188
196
247
237
242
(170–174)
(196–232)
(188–223)
(164–180)
(202–224)
(190–209)
(147–159)
(158–169)
(104–121)
(151–162)
(139–155)
(148–163)
(178–197)
(182–210)
(226–268)
(222–252)
(219–265)
3,143
4,249
3,623
3,228
4,245
3,572
2,516
2,966
2,041
2,965
2,704
2,975
3,716
3,613
4,475
3,994
4,766
(3,080–3,205)
(3,666–4,831)
(3,107–4,139)
(2,982–3,474)
(3,898–4,591)
(3,316–3,827)
(2,373–2,660)
(2,816–3,116)
(1,778–2,304)
(2,805–3,125)
(2,454–2,954)
(2,752–3,197)
(3,404–4,027)
(3,181–4,046)
(3,910–5,041)
(3,626–4,363)
(4,162–5,370)
Yukon
270
(234–305)
5,335
(4,374–6,296)
Northwest Territories
291
(253–328)
5,914
(5,088–6,740)
Nunavut
474
(405–543)
9,664
(8,424–10,905)
Canada
187
(186–188)
3,428
(3,404–3,452)
Age-Standardized
PYLL† per 100,000
95% CI
† Potential years of life lost.
Potentially avoidable mortality
Deaths before age 75 that could potentially have been avoided through all levels of prevention (primary, secondary, tertiary). Expressed as
the age-standardized mortality rate and potential years of life lost (PYLL) per 100,000 population. PYLL is the number of years of potential
life not lived when a person dies before age 75. Avoidable mortality refers to untimely deaths that should not occur in the presence of timely
and effective health care or other public health practices, programs and policy interventions. It serves to focus attention on the portion of
population health attainment that can potentially be influenced by the health system.
Note: Rates are based on three years of pooled data.
Source: Vital Statistics—Death Database, Statistics Canada.
65
Health Indicators 2012
Avoidable Mortality From Preventable Causes
2006 –2008
Map
Code Health Region
Newfoundland and Labrador
1011 Eastern
1012 Central
1013 Western
Age-Standardized
Mortality Rate
per 100,000
95% CI
Age-Standardized
PYLL† per 100,000
95% CI
132
133
114
140
(127–138)
(126–140)
(102–125)
(126–154)
2,285
2,124
2,061
2,566
(2,133–2,437)
(1,943–2,306)
(1,702–2,420)
(2,138–2,994)
Prince Edward Island
126
(116–136)
2,174
(1,903–2,445)
Nova
1211
1212
1223
1234
1258
1269
136
132
146
130
143
166
123
(132–140)
(117–148)
(129–162)
(116–143)
(128–158)
(153–178)
(117–129)
2,359
2,629
2,550
2,390
2,509
3,063
2,002
(2,249–2,469)
(2,091–3,167)
(2,088–3,013)
(1,995–2,786)
(2,099–2,920)
(2,691–3,435)
(1,859–2,145)
New Brunswick
1301 Zone 1 (Moncton area)
1302 Zone 2 (Saint John area)
1303 Zone 3 (Fredericton area)
1306 Zone 6 (Bathurst area)
134
123
143
135
110
(129–138)
(115–132)
(133–153)
(125–145)
(98–123)
2,393
2,328
2,367
2,268
2,088
(2,267–2,520)
(2,086–2,570)
(2,117–2,618)
(2,021–2,516)
(1,704–2,471)
Quebec
2401 Bas-Saint-Laurent
2402 Saguenay–Lac-Saint-Jean
2403 Capitale-Nationale
2404 Mauricie et Centre-du-Québec
2405 Estrie
2406 Montréal
2407 Outaouais
2408 Abitibi-Témiscamingue
2409 Côte-Nord
2411 Gaspésie–Îles-de-la-Madeleine
2412 Chaudière-Appalaches
2413 Laval
2414 Lanaudière
2415 Laurentides
2416 Montérégie
124
131
128
115
141
121
117
145
147
161
167
114
103
135
132
117
(122–125)
(122–140)
(120–135)
(111–120)
(136–147)
(114–128)
(114–119)
(138–152)
(136–159)
(147–175)
(153–182)
(109–120)
(97–108)
(129–141)
(126–137)
(114–120)
2,149
2,690
2,391
2,002
2,693
2,276
1,877
2,273
2,672
2,911
3,209
2,142
1,678
2,299
2,258
1,990
(2,113–2,184)
(2,404–2,975)
(2,175–2,606)
(1,885–2,118)
(2,521–2,864)
(2,080–2,472)
(1,815–1,940)
(2,112–2,433)
(2,371–2,973)
(2,520–3,302)
(2,760–3,659)
(1,979–2,305)
(1,539–1,818)
(2,142–2,457)
(2,117–2,399)
(1,910–2,071)
Ontario
3501 Erie St. Clair
3502 South West
3503 Waterloo Wellington
3504 Hamilton Niagara Haldimand Brant
3505 Central West
3506 Mississauga Halton
3507 Toronto Central
3508 Central
3509 Central East
3510 South East
3511 Champlain
3512 North Simcoe Muskoka
3513 North East
3514 North West
110
126
118
100
121
86
77
101
72
101
131
100
123
149
167
(109–111)
(121–131)
(114–121)
(96–104)
(118–124)
(82–90)
(74–80)
(98–104)
(70–75)
(98–104)
(126–137)
(97–104)
(117–128)
(144–155)
(157–176)
1,851
2,084
2,037
1,665
2,047
1,486
1,235
1,693
1,204
1,644
2,203
1,614
2,111
2,615
3,759
(1,826–1,875)
(1,968–2,199)
(1,936–2,137)
(1,566–1,764)
(1,967–2,127)
(1,396–1,577)
(1,167–1,303)
(1,619–1,767)
(1,147–1,260)
(1,576–1,712)
(2,058–2,348)
(1,540–1,688)
(1,961–2,262)
(2,466–2,765)
(3,459–4,058)
Manitoba
4610 Winnipeg
4615 Brandon
4625 South Eastman
4630 Interlake
4640 Central
4645 Assiniboine
143
130
139
102
152
132
155
(139–147)
(125–135)
(120–158)
(86–117)
(137–168)
(119–145)
(138–172)
2,813
2,311
2,325
1,562
3,032
2,596
3,298
(2,703–2,922)
(2,188–2,434)
(1,874–2,777)
(1,237–1,886)
(2,544–3,520)
(2,235–2,957)
(2,752–3,843)
66
Scotia
South Shore
South West Nova
Annapolis Valley
Colchester East Hants
Cape Breton
Capital
Health System Performance
Avoidable Mortality From Preventable Causes
2006 –2008
Map
Code Health Region
Age-Standardized
Mortality Rate
per 100,000
95% CI
Age-Standardized
PYLL† per 100,000
95% CI
Saskatchewan
4701 Sun Country
4702 Five Hills
4704 Regina
4705 Sunrise
4706 Saskatoon
4709 Prince Albert
4710 Prairie North
142
128
115
132
141
123
174
184
(138–147)
(110–145)
(98–132)
(124–141)
(123–158)
(115–130)
(156–192)
(165–203)
3,020
2,663
2,307
2,551
2,933
2,426
4,083
4,413
(2,892–3,149)
(2,124–3,203)
(1,794–2,820)
(2,324–2,778)
(2,344–3,521)
(2,225–2,627)
(3,504–4,662)
(3,804–5,022)
Alberta
4831 South Zone
4832 Calgary Zone
4833 Central Zone
4834 Edmonton Zone
4835 North Zone
131
138
106
146
123
165
(129–133)
(130–146)
(102–109)
(140–153)
(119–127)
(157–172)
2,532
2,872
1,924
2,970
2,230
3,451
(2,475–2,589)
(2,645–3,100)
(1,843–2,004)
(2,784–3,156)
(2,138–2,323)
(3,249–3,652)
British Columbia
5911 East Kootenay
5912 Kootenay Boundary
5913 Okanagan
5914 Thompson/Cariboo/Shuswap
5921 Fraser East
5922 Fraser North
5923 Fraser South
5931 Richmond
5932 Vancouver
5933 North Shore
5941 South Vancouver Island
5942 Central Vancouver Island
5943 North Vancouver Island
5951 Northwest
5952 Northern Interior
5953 Northeast
114
155
142
116
148
134
103
104
70
101
97
102
128
133
175
160
160
(112–116)
(140–171)
(127–157)
(110–122)
(139–156)
(126–142)
(98–108)
(100–109)
(63–77)
(97–106)
(90–104)
(96–108)
(121–136)
(122–144)
(157–193)
(148–172)
(141–179)
2,078
3,277
2,727
2,175
3,021
2,452
1,645
1,855
1,192
1,810
1,812
1,944
2,537
2,447
3,309
2,733
3,259
(2,031–2,125)
(2,762–3,791)
(2,268–3,185)
(1,987–2,364)
(2,741–3,301)
(2,245–2,658)
(1,539–1,751)
(1,745–1,965)
(1,020–1,363)
(1,706–1,914)
(1,619–2,005)
(1,785–2,102)
(2,293–2,782)
(2,117–2,778)
(2,820–3,797)
(2,441–3,024)
(2,773–3,744)
Yukon
184
(154–213)
3,796
(3,025–4,568)
Northwest Territories
190
(160–219)
4,090
(3,414–4,767)
Nunavut
344
(285–404)
6,837
(5,791–7,883)
Canada
120
(120–121)
2,141
(2,124–2,159)
† Potential years of life lost.
Avoidable mortality from preventable causes
Mortality from preventable causes is a subset of potentially avoidable mortality, representing deaths before age 75 that could potentially
have been prevented through primary prevention efforts. Expressed as the age-standardized mortality rate and potential years of life lost
(PYLL) per 100,000 population. PYLL is the number of years of potential life not lived when a person dies before age 75. This indicator
informs efforts to reduce the number of initial cases (that is, incidence reduction); through these efforts, deaths can be prevented by avoiding
new cases altogether.
Note: Rates are based on three years of pooled data.
Source: Vital Statistics—Death Database, Statistics Canada.
67
Health Indicators 2012
Avoidable Mortality From Treatable Causes
2006 –2008
Map
Code Health Region
Newfoundland and Labrador
1011 Eastern
1012 Central
1013 Western
Age-Standardized
Mortality Rate
per 100,000
95% CI
Age-Standardized
PYLL† per 100,000
95% CI
88
91
74
84
(83–92)
(85–97)
(65–83)
(73–95)
1,682
1,819
1,200
1,616
(1,520–1,845)
(1,595–2,043)
(902–1,498)
(1,206–2,025)
75
(67–83)
1,294
(1,052–1,537)
72
56
67
65
74
100
68
(69–75)
(46–66)
(56–77)
(56–75)
(63–84)
(90–109)
(63–73)
1,227
925
967
1,036
1,303
1,803
1,125
(1,135–1,318)
(584–1,267)
(681–1,254)
(751–1,322)
(966–1,641)
(1,482–2,125)
(1,001–1,249)
New Brunswick
1301 Zone 1 (Moncton area)
1302 Zone 2 (Saint John area)
1303 Zone 3 (Fredericton area)
1306 Zone 6 (Bathurst area)
61
54
66
65
52
(58–64)
(49–60)
(59–73)
(58–72)
(44–61)
1,108
1,088
1,145
1,145
*802
(1,005–1,212)
(881–1,295)
(944–1,346)
(933–1,357)
(530–1,075)
Quebec
2401 Bas-Saint-Laurent
2402 Saguenay–Lac-Saint-Jean
2403 Capitale-Nationale
2404 Mauricie et Centre-du-Québec
2405 Estrie
2406 Montréal
2407 Outaouais
2408 Abitibi-Témiscamingue
2409 Côte-Nord
2411 Gaspésie–Îles-de-la-Madeleine
2412 Chaudière-Appalaches
2413 Laval
2414 Lanaudière
2415 Laurentides
2416 Montérégie
64
56
64
58
64
56
68
71
68
74
78
55
60
62
66
64
(63–65)
(50–61)
(59–69)
(55–62)
(60–67)
(52–61)
(66–70)
(66–76)
(61–76)
(65–84)
(68–88)
(51–59)
(55–64)
(58–66)
(62–69)
(62–66)
1,227
1,116
1,283
1,146
1,316
1,118
1,286
1,076
1,216
1,487
1,731
1,163
1,265
1,130
1,242
1,170
(1,193–1,260)
(904–1,328)
(1,094–1,473)
(1,030–1,261)
(1,167–1,466)
(954–1,282)
(1,219–1,354)
(948–1,204)
(996–1,435)
(1,150–1,824)
(1,287–2,174)
(1,011–1,314)
(1,106–1,425)
(1,001–1,260)
(1,114–1,369)
(1,096–1,244)
Ontario
3501 Erie St. Clair
3502 South West
3503 Waterloo Wellington
3504 Hamilton Niagara Haldimand Brant
3505 Central West
3506 Mississauga Halton
3507 Toronto Central
3508 Central
3509 Central East
3510 South East
3511 Champlain
3512 North Simcoe Muskoka
3513 North East
3514 North West
67
72
68
60
69
60
53
63
51
62
72
65
69
81
81
(66–68)
(68–76)
(65–71)
(57–64)
(67–72)
(57–63)
(51–56)
(60–66)
(49–54)
(60–65)
(68–76)
(62–67)
(65–74)
(77–85)
(74–87)
1,308
1,267
1,305
1,107
1,279
1,360
1,053
1,249
1,066
1,314
1,471
1,198
1,319
1,573
1,656
(1,281–1,335)
(1,158–1,376)
(1,204–1,406)
(1,008–1,207)
(1,199–1,359)
(1,248–1,471)
(974–1,132)
(1,164–1,335)
(995–1,136)
(1,231–1,396)
(1,311–1,630)
(1,114–1,282)
(1,169–1,468)
(1,423–1,722)
(1,434–1,879)
Manitoba
4610 Winnipeg
4615 Brandon
4625 South Eastman
4630 Interlake
4640 Central
4645 Assiniboine
83
81
77
58
88
78
81
(80–86)
(77–84)
(63–91)
(46–69)
(77–100)
(68–88)
(69–92)
1,679
1,676
1,365
1,023
1,636
1,607
1,545
(1,583–1,775)
(1,542–1,809)
(978–1,751)
(725–1,322)
(1,257–2,015)
(1,303–1,911)
(1,152–1,939)
Prince Edward Island
Nova
1211
1212
1223
1234
1258
1269
68
Scotia
South Shore
South West Nova
Annapolis Valley
Colchester East Hants
Cape Breton
Capital
Health System Performance
Avoidable Mortality From Treatable Causes
2006 –2008
Map
Code Health Region
Age-Standardized
Mortality Rate
per 100,000
95% CI
Age-Standardized
PYLL† per 100,000
95% CI
Saskatchewan
4701 Sun Country
4702 Five Hills
4704 Regina
4705 Sunrise
4706 Saskatoon
4709 Prince Albert
4710 Prairie North
80
68
81
76
81
76
94
88
(77–83)
(56–81)
(67–94)
(69–82)
(68–94)
(70–81)
(82–107)
(75–101)
1,532
1,154
1,302
1,472
1,530
1,384
1,857
1,747
(1,434–1,630)
(803–1,504)
(936–1,668)
(1,271–1,672)
(1,076–1,984)
(1,218–1,551)
(1,471–2,243)
(1,372–2,122)
Alberta
4831 South Zone
4832 Calgary Zone
4833 Central Zone
4834 Edmonton Zone
4835 North Zone
67
66
55
75
66
79
(66–69)
(60–71)
(53–58)
(70–80)
(63–68)
(73–84)
1,339
1,378
1,072
1,446
1,311
1,457
(1,290–1,387)
(1,199–1,557)
(999–1,144)
(1,305–1,588)
(1,224–1,398)
(1,322–1,592)
British Columbia
5911 East Kootenay
5912 Kootenay Boundary
5913 Okanagan
5914 Thompson/Cariboo/Shuswap
5921 Fraser East
5922 Fraser North
5923 Fraser South
5931 Richmond
5932 Vancouver
5933 North Shore
5941 South Vancouver Island
5942 Central Vancouver Island
5943 North Vancouver Island
5951 Northwest
5952 Northern Interior
5953 Northeast
58
59
63
56
65
65
50
60
43
56
50
53
59
63
72
77
83
(56–59)
(49–68)
(54–72)
(52–60)
(60–71)
(60–71)
(47–54)
(56–63)
(37–48)
(52–59)
(45–55)
(49–58)
(54–64)
(55–71)
(61–84)
(69–86)
(69–96)
1,065
972
897
1,053
1,210
1,120
872
1,111
850
1,155
892
1,028
1,178
1,166
1,167
1,262
1,507
(1,023–1,106)
(699–1,245)
(659–1,134)
(895–1,210)
(1,007–1,413)
(969–1,271)
(775–968)
(1,008–1,213)
(651–1,048)
(1,033–1,276)
(733–1,052)
(872–1,185)
(984–1,372)
(887–1,445)
(881–1,452)
(1,037–1,487)
(1,148–1,867)
Yukon
86
(66–107)
1,539
(966–2,112)
Northwest Territories
100
(78–123)
1,804
(1,332–2,275)
Nunavut
130
(94–166)
2,827
(2,159–3,496)
Canada
66
(66–67)
1,286
(1,270–1,303)
† Potential years of life lost.
Avoidable mortality from treatable causes
Mortality from treatable causes is a subset of potentially avoidable mortality, representing deaths before age 75 that could potentially have
been avoided through secondary or tertiary prevention. Expressed as the age-standardized mortality rate and potential years of life lost
(PYLL) per 100,000 population. PYLL is the number of years of potential life not lived when a person dies before age 75. The indicator
informs efforts aimed at reducing the number of people who die once they have the condition, or case-fatality reduction.
Note: Rates are based on three years of pooled data.
Source: Vital Statistics—Death Database, Statistics Canada.
69
Health Indicators 2012
Hospitalized Hip Fracture Event
Map
Code
Health Region
2010 –2011
Age-Standardized
Rate per 100,000
95% CI
Risk-Adjusted Rate (%)
95% CI
77.6
73.1
88.2
81.5
(73.9–81.3)
(68.3–78.0)
(79.2–97.1)
(73.0–90.0)
(421–594)
79.6
(72.7–86.5)
(446–510)
(307–519)
(335–560)
(482–710)
(365–601)
(440–614)
(389–494)
79.9
89.3
93.7
94.0
70.9
85.9
66.9
(77.2–82.7)
(77.7–100.0)
(84.1–100.0)
(86.3–100.0)
(60.5–81.3)
(79.4–92.5)
(62.0–71.9)
(389–409)
(329–443)
(290–391)
(378–446)
(346–420)
(304–399)
(420–464)
(348–463)
(352–522)
(232–423)
(323–500)
(332–420)
(344–437)
(343–439)
(350–437)
(378–430)
81.3
80.5
83.1
78.9
93.7
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
(78.1–84.4)
(74.5–86.6)
(76.0–90.3)
(72.6–85.1)
(82.6–100.0)
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
432
483
491
495
443
367
387
382
416
413
482
411
472
482
538
(424–441)
(444–523)
(458–524)
(453–536)
(418–469)
(329–405)
(355–419)
(355–409)
(390–441)
(388–437)
(438–525)
(383–439)
(425–519)
(441–523)
(467–609)
78.7
77.3
63.8
92.2
80.5
66.0
78.3
79.4
81.2
77.3
81.2
85.9
72.5
81.2
82.2
(77.9–79.5)
(73.7–80.9)
(61.0–66.6)
(88.8–95.6)
(78.2–82.9)
(61.6–70.5)
(74.6–82.0)
(76.5–82.3)
(78.7–83.7)
(74.8–79.7)
(77.5–84.9)
(83.1–88.6)
(68.3–76.8)
(77.6–84.7)
(76.6–87.9)
504
507
685
325
457
413
467
(474–535)
(467–547)
(515–854)
(201–448)
(345–568)
(317–509)
(363–572)
87.0
86.6
93.5
*
94.5
78.5
90.2
(84.6–89.4)
(83.5–89.7)
(83.1–100.0)
**
(84.4–100.0)
(69.6–87.5)
(81.9–98.5)
Newfoundland and Labrador
1011 Eastern
1012 Central
1013 Western
546
566
444
631
Prince Edward Island
508
Nova
1211
1212
1223
1234
1258
1269
478
413
448
596
483
527
442
New Brunswick
1301 Zone 1 (Moncton area)
1302 Zone 2 (Saint John area)
1303 Zone 3 (Fredericton area)
1306 Zone 6 (Bathurst area)
474
413
522
583
320
(438–511)
(350–477)
(441–603)
(495–671)
(232–408)
Quebec
2401 Bas-Saint-Laurent
2402 Saguenay–Lac-Saint-Jean
2403 Capitale-Nationale
2404 Mauricie et Centre-du-Québec
2405 Estrie
2406 Montréal
2407 Outaouais
2408 Abitibi-Témiscamingue
2409 Côte-Nord
2411 Gaspésie–Îles-de-la-Madeleine
2412 Chaudière-Appalaches
2413 Laval
2414 Lanaudière
2415 Laurentides
2416 Montérégie
399
386
340
412
383
351
442
405
437
328
412
376
390
391
393
404
Ontario
3501 Erie St. Clair
3502 South West
3503 Waterloo Wellington
3504 Hamilton Niagara Haldimand Brant
3505 Central West
3506 Mississauga Halton
3507 Toronto Central
3508 Central
3509 Central East
3510 South East
3511 Champlain
3512 North Simcoe Muskoka
3513 North East
3514 North West
Manitoba
4610 Winnipeg
4615 Brandon
4625 South Eastman
4630 Interlake
4640 Central
4645 Assiniboine
70
Scotia
South Shore
South West Nova
Annapolis Valley
Colchester East Hants
Cape Breton
Capital
Wait Time for Hip Fracture Surgery
(Proportion With Surgery Within 48 Hours)
2010 –2011
(496–596)
(498–635)
(348–541)
(504–759)
Health System Performance
Hospitalized Hip Fracture Event
Map
Code
Health Region
2010 –2011
Age-Standardized
Rate per 100,000
95% CI
Wait Time for Hip Fracture Surgery
(Proportion With Surgery Within 48 Hours)
2010 –2011
Risk-Adjusted Rate (%)
95% CI
Saskatchewan
4701 Sun Country
4702 Five Hills
4704 Regina
4705 Sunrise
4706 Saskatoon
4709 Prince Albert
4710 Prairie North
492
476
641
528
447
488
350
342
(461–524)
(353–599)
(499–783)
(460–596)
(338–557)
(426–549)
(253–447)
(235–449)
77.1
87.7
68.2
82.5
76.6
73.1
79.9
74.2
(74.6–79.6)
(78.0–97.4)
(59.9–76.6)
(77.5–87.6)
(67.7–85.4)
(68.0–78.1)
(68.8–91.0)
(61.5–86.9)
Alberta
4831 South Zone
4832 Calgary Zone
4833 Central Zone
4834 Edmonton Zone
4835 North Zone
466
544
453
452
438
542
(446–485)
(478–610)
(419–487)
(401–502)
(404–471)
(471–614)
83.1
85.9
86.0
74.4
84.5
77.7
(81.4–84.9)
(80.9–90.8)
(82.9–89.1)
(69.8–79.0)
(81.4–87.7)
(72.1–83.4)
British Columbia
5911 East Kootenay
5912 Kootenay Boundary
5913 Okanagan
5914 Thompson/Cariboo/Shuswap
5921 Fraser East
5922 Fraser North
5923 Fraser South
5931 Richmond
5932 Vancouver
5933 North Shore
5941 South Vancouver Island
5942 Central Vancouver Island
5943 North Vancouver Island
5951 Northwest
5952 Northern Interior
5953 Northeast
451
522
459
462
506
451
467
431
329
395
490
464
517
530
561
552
431
(437–466)
(410–634)
(359–559)
(417–507)
(437–574)
(391–511)
(421–513)
(395–467)
(265–394)
(355–434)
(430–549)
(417–511)
(461–574)
(434–625)
(401–721)
(442–662)
(266–597)
81.0
84.9
92.4
80.6
82.7
70.3
70.6
66.3
88.0
83.6
84.4
90.4
91.3
94.7
67.5
87.7
*
(79.7–82.3)
(76.2–93.6)
(83.3–100.0)
(76.7–84.5)
(76.8–88.6)
(64.5–76.2)
(66.6–74.6)
(62.7–70.0)
(80.2–95.8)
(79.7–87.6)
(79.4–89.3)
(86.5–94.2)
(86.9–95.7)
(87.1–100.0)
(55.2–79.7)
(79.0–96.3)
**
Yukon
382
(141–623)
*
**
Northwest Territories
967
(565–1,369)
66.8
(47.1–86.5)
**
Nunavut
Canada
*
**
*
439
(434–445)
80.1
Hospitalized hip fracture event
Age-standardized rate of new hip fractures admitted to an acute care hospital, per 100,000 population age 65 and older. New event is
defined as a first-ever hospitalization for hip fracture or a subsequent hip fracture occurring more than 28 days after the admission for the
previous event in the reference period. Hip fractures represent a significant health burden for seniors and for the health system. As well as
causing disability or death, hip fracture may have a major effect on independence and quality of life. This indicator is important for planning
and evaluating preventive strategies, allocating health resources and estimating costs.
Sources: Discharge Abstract Database, Canadian Institute for Health Information; Fichier des hospitalisations MED-ÉCHO, ministère de la Santé et des
Services sociaux du Québec.
Wait time for hip fracture surgery
Proportion with surgery within 48 hours: Risk-adjusted proportion of hip fracture patients age 65 and older who underwent hip fracture
surgery within 48 hours of admission. While some hip fracture patients need medical treatment to stabilize their condition before surgery,
research suggests patients typically benefit from timely surgery in terms of reduced morbidity, mortality, pain and length of stay in hospital,
as well as improved rehabilitation. This indicator is intended to provide a comparable measure of access to care across the country and to
be used as a tool to identify opportunities for improvement, using a national data source.
Note: Rates for Quebec are not available due to differences in data collection; the Canada rate does not include Quebec.
Source: Discharge Abstract Database, Canadian Institute for Health Information.
71
Health Indicators 2012
Ambulatory Care Sensitive Conditions
2010 –2011
Map
Code
Caesarean Section
2010 –2011
Age-Standardized
Rate per 100,000
95% CI
%
95% CI
Newfoundland and Labrador
1011 Eastern
1012 Central
1013 Western
461
408
527
530
(443–479)
(386–431)
(479–574)
(480–579)
31.9
31.8
33.1
31.0
(30.5–33.2)
(30.1–33.5)
(29.7–36.5)
(27.4–34.6)
Prince Edward Island
515
(478–552)
31.8
(29.4–34.3)
Nova
1211
1212
1223
1234
1258
1269
334
337
480
316
322
506
227
(323–345)
(290–384)
(426–534)
(280–352)
(283–360)
(466–546)
(213–242)
27.2
25.2
31.4
26.4
28.6
28.1
26.4
(26.3–28.1)
(20.9–29.5)
(27.0–35.8)
(23.3–29.6)
(25.3–31.8)
(25.3–30.9)
(25.1–27.7)
New Brunswick
1301 Zone 1 (Moncton area)
1302 Zone 2 (Saint John area)
1303 Zone 3 (Fredericton area)
1306 Zone 6 (Bathurst area)
474
381
430
520
511
(459–489)
(355–408)
(400–461)
(487–553)
(462–560)
27.4
29.7
21.6
28.6
27.9
(26.4–28.4)
(27.6–31.7)
(19.7–23.5)
(26.5–30.7)
(24.1–31.7)
Quebec
2401 Bas-Saint-Laurent
2402 Saguenay–Lac-Saint-Jean
2403 Capitale-Nationale
2404 Mauricie et Centre-du-Québec
2405 Estrie
2406 Montréal
2407 Outaouais
2408 Abitibi-Témiscamingue
2409 Côte-Nord
2411 Gaspésie–Îles-de-la-Madeleine
2412 Chaudière-Appalaches
2413 Laval
2414 Lanaudière
2415 Laurentides
2416 Montérégie
289
322
412
231
313
310
258
315
414
463
583
261
198
291
271
299
(285–292)
(299–346)
(388–436)
(220–242)
(298–328)
(291–329)
(251–265)
(296–333)
(382–447)
(421–505)
(538–628)
(246–276)
(185–212)
(276–307)
(257–284)
(290–307)
23.0
22.1
20.8
24.4
20.0
19.7
24.4
26.8
23.5
18.6
28.2
24.1
23.0
19.4
20.6
23.0
(22.7–23.3)
(20.2–24.0)
(19.3–22.4)
(23.4–25.4)
(18.8–21.1)
(18.3–21.1)
(23.9–25.0)
(25.4–28.1)
(21.4–25.5)
(16.2–20.9)
(24.9–31.4)
(22.8–25.3)
(21.8–24.3)
(18.3–20.5)
(19.6–21.7)
(22.3–23.7)
Ontario
3501 Erie St. Clair
3502 South West
3503 Waterloo Wellington
3504 Hamilton Niagara Haldimand Brant
3505 Central West
3506 Mississauga Halton
3507 Toronto Central
3508 Central
3509 Central East
3510 South East
3511 Champlain
3512 North Simcoe Muskoka
3513 North East
3514 North West
274
321
302
245
322
261
196
244
180
252
330
247
329
476
531
(271–277)
(308–335)
(292–313)
(233–256)
(312–331)
(249–272)
(188–204)
(235–253)
(174–187)
(244–260)
(314–346)
(238–256)
(312–345)
(459–494)
(502–560)
28.4
26.0
22.6
26.9
28.2
30.8
27.2
29.9
29.2
30.3
27.7
29.6
30.5
29.5
24.8
(28.2–28.7)
(24.9–27.1)
(21.8–23.5)
(25.9–27.8)
(27.5–29.0)
(30.0–31.7)
(26.4–28.0)
(29.1–30.7)
(28.5–29.8)
(29.6–31.0)
(26.3–29.0)
(28.8–30.4)
(29.1–31.9)
(28.3–30.8)
(23.1–26.4)
Manitoba
4610 Winnipeg
4615 Brandon
4625 South Eastman
4630 Interlake
4640 Central
4645 Assiniboine
329
241
380
236
349
336
500
(319–339)
(229–253)
(326–435)
(198–274)
(311–387)
(301–371)
(447–553)
21.5
22.5
28.9
17.9
17.7
21.8
25.6
(20.9–22.2)
(21.5–23.4)
(25.5–32.3)
(15.5–20.2)
(15.1–20.3)
(19.8–23.8)
(22.6–28.5)
72
Health Region
Scotia
South Shore
South West Nova
Annapolis Valley
Colchester East Hants
Cape Breton
Capital
Health System Performance
Ambulatory Care Sensitive Conditions
2010 –2011
Map
Code
Caesarean Section
2010 –2011
Age-Standardized
Rate per 100,000
95% CI
%
95% CI
Saskatchewan
4701 Sun Country
4702 Five Hills
4704 Regina
4705 Sunrise
4706 Saskatoon
4709 Prince Albert
4710 Prairie North
478
520
435
504
716
296
495
631
(464–491)
(459–580)
(378–493)
(476–532)
(646–785)
(277–316)
(445–544)
(570–691)
22.1
23.0
30.3
22.3
28.4
22.4
15.6
21.1
(21.4–22.8)
(19.8–26.1)
(26.7–34.0)
(20.9–23.7)
(24.7–32.0)
(21.1–23.7)
(13.4–17.7)
(18.9–23.3)
Alberta
4831 South Zone
4832 Calgary Zone
4833 Central Zone
4834 Edmonton Zone
4835 North Zone
309
431
237
408
240
551
(303–314)
(406–455)
(229–246)
(389–427)
(230–249)
(527–575)
27.7
24.3
28.4
28.5
27.8
26.9
(27.3–28.1)
(22.9–25.6)
(27.7–29.0)
(27.3–29.7)
(27.1–28.6)
(25.8–27.9)
British Columbia
5911 East Kootenay
5912 Kootenay Boundary
5913 Okanagan
5914 Thompson/Cariboo/Shuswap
5921 Fraser East
5922 Fraser North
5923 Fraser South
5931 Richmond
5932 Vancouver
5933 North Shore
5941 South Vancouver Island
5942 Central Vancouver Island
5943 North Vancouver Island
5951 Northwest
5952 Northern Interior
5953 Northeast
263
458
316
312
324
333
223
253
156
200
214
181
298
297
520
497
380
(258–267)
(411–505)
(277–356)
(294–331)
(301–347)
(312–354)
(210–235)
(242–265)
(138–175)
(189–211)
(196–231)
(166–195)
(277–319)
(267–326)
(470–570)
(460–533)
(332–428)
31.8
33.7
27.3
29.4
32.9
31.0
34.3
33.0
31.9
32.8
33.9
32.9
26.8
28.8
24.1
27.5
29.8
(31.3–32.2)
(30.4–37.0)
(23.7–30.8)
(27.7–31.1)
(30.8–35.0)
(29.4–32.5)
(33.1–35.6)
(31.9–34.0)
(29.6–34.2)
(31.6–34.0)
(31.9–35.9)
(31.2–34.6)
(24.9–28.7)
(26.0–31.6)
(21.3–26.9)
(25.3–29.7)
(27.0–32.7)
Yukon
504
(428–580)
20.0
(15.9–24.1)
Health Region
Northwest Territories
644
(552–736)
20.4
(17.4–23.4)
Nunavut
913
(760–1,066)
8.7
(6.7–10.7)
Canada
299
(297–301)
26.9
(26.7–27.0)
Ambulatory care sensitive conditions
Age-standardized acute care hospitalization rate for conditions where appropriate ambulatory care prevents or reduces the need for
hospitalization, per 100,000 population younger than age 75. Hospitalizations for ambulatory care sensitive conditions are considered to be
an indirect measure of access to appropriate primary health care. While not all admissions for these conditions are avoidable, appropriate
ambulatory care could potentially prevent the onset of this type of illness or condition, control an acute episodic illness or condition, or
manage a chronic disease or condition.
Sources: Discharge Abstract Database, Canadian Institute for Health Information; Fichier des hospitalisations MED-ÉCHO, ministère de la Santé et des
Services sociaux du Québec.
Caesarean section
Proportion of women delivering babies in acute care hospitals by Caesarean section. Caesarean section rates provide information on the
frequency of surgical birth delivery relative to all modes of birth delivery. Since unnecessary Caesarean section delivery increases maternal
morbidity/mortality and is associated with higher costs, Caesarean section rates are often used to monitor clinical practices, with an implicit
assumption that lower rates indicate more appropriate, as well as more efficient, care.
Sources: Discharge Abstract Database, Canadian Institute for Health Information; Fichier des hospitalisations MED-ÉCHO, ministère de la Santé et des
Services sociaux du Québec.
73
Health Indicators 2012
Map
Code
30-Day Acute Myocardial Infarction
In-Hospital Mortality
2008–2009 to 2010 –2011
Health Region
30-Day Stroke
In-Hospital Mortality
2008–2009 to 2010 –2011
Risk-Adjusted Rate (%)
95% CI
Risk-Adjusted Rate (%)
95% CI
Newfoundland and Labrador
1011 Eastern
1012 Central
1013 Western
8.0
7.8
8.7
6.9
(7.1–8.8)
(6.7–9.0)
(6.9–10.5)
(4.5–9.4)
19.9
19.0
24.8
18.0
(18.1–21.6)
(16.7–21.3)
(20.9–28.7)
(13.3–22.7)
Prince Edward Island
8.1
(6.4–9.9)
18.7
(15.4–22.1)
Nova
1211
1212
1223
1234
1258
1269
7.3
5.6
7.5
5.2
6.6
8.0
7.3
(6.6–8.0)
(3.4–7.8)
(5.2–9.8)
(3.1–7.4)
(4.6–8.5)
(6.4–9.7)
(6.0–8.6)
18.9
16.3
22.4
18.3
18.7
16.0
18.7
(17.5–20.2)
(12.0–20.6)
(18.0–26.9)
(14.0–22.7)
(14.2–23.3)
(12.4–19.5)
(16.3–21.1)
Quebec
2401 Bas-Saint-Laurent
2402 Saguenay–Lac-Saint-Jean
2403 Capitale-Nationale
2404 Mauricie et Centre-du-Québec
2405 Estrie
2406 Montréal
2407 Outaouais
2408 Abitibi-Témiscamingue
2409 Côte-Nord
2411 Gaspésie–Îles-de-la-Madeleine
2412 Chaudière-Appalaches
2413 Laval
2414 Lanaudière
2415 Laurentides
2416 Montérégie
7.7
7.3
8.3
7.7
9.5
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
(6.9–8.5)
(5.8–8.9)
(6.6–10.0)
(6.1–9.2)
(6.8–12.2)
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
16.3
16.4
18.5
15.9
17.5
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
(14.8–17.8)
(13.5–19.2)
(15.3–21.7)
(12.6–19.1)
(12.9–22.0)
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
Ontario
3501 Erie St. Clair
3502 South West
3503 Waterloo Wellington
3504 Hamilton Niagara Haldimand Brant
3505 Central West
3506 Mississauga Halton
3507 Toronto Central
3508 Central
3509 Central East
3510 South East
3511 Champlain
3512 North Simcoe Muskoka
3513 North East
3514 North West
8.1
8.3
8.3
7.9
8.0
7.1
7.9
7.6
8.7
7.9
8.6
7.3
9.1
9.7
6.7
(7.9–8.3)
(7.4–9.1)
(7.5–9.0)
(7.0–8.8)
(7.4–8.5)
(6.1–8.0)
(7.0–8.7)
(6.8–8.3)
(8.1–9.4)
(7.3–8.6)
(7.7–9.6)
(6.6–8.0)
(8.0–10.1)
(8.9–10.5)
(5.5–7.9)
15.9
15.8
17.9
16.6
16.5
14.3
15.9
14.7
13.5
15.4
19.7
15.9
14.7
18.8
15.6
(15.6–16.3)
(14.3–17.2)
(16.6–19.1)
(15.0–18.2)
(15.4–17.5)
(12.7–15.9)
(14.6–17.3)
(13.5–15.9)
(12.4–14.6)
(14.4–16.5)
(18.0–21.4)
(14.6–17.2)
(12.9–16.5)
(17.3–20.3)
(13.2–18.0)
7.0
6.1
7.6
8.2
8.1
10.2
8.6
(6.4–7.6)
(5.3–6.9)
(4.7–10.6)
(5.1–11.3)
(5.8–10.4)
(8.1–12.3)
(6.0–11.1)
16.2
14.1
17.7
18.7
18.1
15.6
26.6
(15.0–17.4)
(12.5–15.6)
(11.5–23.9)
(13.1–24.3)
(13.1–23.1)
(11.5–19.7)
(22.0–31.2)
Scotia
South Shore
South West Nova
Annapolis Valley
Colchester East Hants
Cape Breton
Capital
New Brunswick
1301 Zone 1 (Moncton area)
1302 Zone 2 (Saint John area)
1303 Zone 3 (Fredericton area)
1306 Zone 6 (Bathurst area)
Manitoba
4610 Winnipeg
4615 Brandon
4625 South Eastman
4630 Interlake
4640 Central
4645 Assiniboine
74
Health System Performance
Map
Code
30-Day Acute Myocardial Infarction
In-Hospital Mortality
2008–2009 to 2010 –2011
Health Region
Saskatchewan
4701 Sun Country
4702 Five Hills
4704 Regina
4705 Sunrise
4706 Saskatoon
4709 Prince Albert
4710 Prairie North
Alberta
4831 South Zone
4832 Calgary Zone
4833 Central Zone
4834 Edmonton Zone
4835 North Zone
British Columbia
5911 East Kootenay
5912 Kootenay Boundary
5913 Okanagan
5914 Thompson/Cariboo/Shuswap
5921 Fraser East
5922 Fraser North
5923 Fraser South
5931 Richmond
5932 Vancouver
5933 North Shore
5941 South Vancouver Island
5942 Central Vancouver Island
5943 North Vancouver Island
5951 Northwest
5952 Northern Interior
5953 Northeast
Yukon
30-Day Stroke
In-Hospital Mortality
2008–2009 to 2010 –2011
Risk-Adjusted Rate (%)
95% CI
Risk-Adjusted Rate (%)
95% CI
7.6
7.9
8.4
8.4
10.1
6.8
7.4
7.5
(6.9–8.4)
(4.6–11.2)
(5.6–11.1)
(6.9–9.9)
(7.4–12.8)
(5.4–8.2)
(4.9–9.9)
(4.7–10.3)
16.3
17.1
14.8
18.5
18.6
12.7
18.3
16.3
(15.0–17.5)
(11.2–23.0)
(9.8–19.7)
(15.9–21.2)
(14.2–23.1)
(10.3–15.1)
(13.8–22.9)
(11.2–21.5)
6.7
8.7
5.5
8.4
6.0
6.9
(6.2–7.1)
(7.3–10.1)
(4.6–6.4)
(7.2–9.5)
(5.2–6.8)
(5.4–8.4)
14.2
16.1
11.6
18.5
13.0
18.2
(13.4–15.0)
(13.4–18.7)
(10.2–13.0)
(16.4–20.6)
(11.6–14.4)
(15.6–20.9)
7.7
7.1
7.4
6.5
8.8
7.9
8.3
7.1
10.3
7.6
7.3
7.7
8.2
6.9
8.7
9.7
11.4
(7.4–8.1)
(4.7–9.4)
(5.2–9.6)
(5.4–7.6)
(7.3–10.2)
(6.4–9.3)
(7.1–9.6)
(6.1–8.1)
(8.1–12.5)
(6.5–8.7)
(5.8–8.8)
(6.3–9.1)
(6.8–9.6)
(4.4–9.4)
(4.9–12.6)
(7.2–12.3)
(7.5–15.4)
15.9
20.4
19.8
14.5
15.2
17.0
15.6
15.7
12.4
14.4
13.2
20.7
14.2
19.9
20.6
16.3
21.1
(15.3–16.5)
(15.8–25.0)
(15.9–23.8)
(12.7–16.3)
(12.7–17.8)
(14.6–19.4)
(13.8–17.4)
(14.1–17.4)
(9.4–15.4)
(12.7–16.1)
(10.8–15.5)
(18.6–22.9)
(11.8–16.5)
(16.4–23.5)
(15.2–26.0)
(12.4–20.2)
(13.8–28.4)
*
**
19.9
(11.8–28.0)
Northwest Territories
*
**
7.2
(3.3–14.7)
Nunavut
*
**
*
**
Canada
7.8
16.0
30-day acute myocardial infarction in-hospital mortality
The risk-adjusted rate of all-cause in-hospital death occurring within 30 days of first admission to an acute care hospital with a diagnosis of
acute myocardial infarction (AMI, or heart attack). Rates are based on three years of pooled data.
Note: Rates for Quebec are not available due to differences in data collection; the Canada rate does not include Quebec.
Source: Discharge Abstract Database, Canadian Institute for Health Information.
30-day stroke in-hospital mortality
The risk-adjusted rate of all-cause in-hospital death occurring within 30 days of first admission to an acute care hospital with a diagnosis of
stroke. Rates are based on three years of pooled data.
Note: Rates for Quebec are not available due to differences in data collection; the Canada rate does not include Quebec.
Source: Discharge Abstract Database, Canadian Institute for Health Information.
75
Health Indicators 2012
Acute Myocardial Infarction Readmission
2008–2009 to 2010 –2011
Map
Code Health Region
Risk-Adjusted Rate (%)
95% CI
5.2
5.0
5.3
5.2
(4.6–5.9)
(4.1–5.8)
(4.0–6.7)
(3.5–7.0)
13.8
13.2
15.1
13.5
(13.3–14.3)
(12.5–13.9)
(14.1–16.2)
(12.3–14.6)
Prince Edward Island
4.8
(3.5–6.2)
13.7
(12.8–14.5)
Nova
1211
1212
1223
1234
1258
1269
4.5
5.3
4.6
4.9
5.8
4.7
3.3
(4.0–5.1)
(3.5–7.1)
(2.7–6.6)
(3.1–6.7)
(4.0–7.6)
(3.4–6.0)
(2.2–4.4)
12.1
11.3
12.2
12.1
12.7
12.8
10.8
(11.7–12.5)
(9.7–12.8)
(10.9–13.6)
(10.7–13.5)
(11.1–14.2)
(11.8–13.8)
(10.0–11.6)
(4.0–5.3)
(2.7–5.2)
(0.9–3.6)
(3.8–6.4)
(1.9–6.1)
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
13.0
12.7
12.1
13.4
12.9
(12.6–13.4)
(12.0–13.5)
(11.2–13.0)
(12.6–14.2)
(11.8–14.1)
Quebec
2401 Bas-Saint-Laurent
2402 Saguenay–Lac-Saint-Jean
2403 Capitale-Nationale
2404 Mauricie et Centre-du-Québec
2405 Estrie
2406 Montréal
2407 Outaouais
2408 Abitibi-Témiscamingue
2409 Côte-Nord
2411 Gaspésie–Îles-de-la-Madeleine
2412 Chaudière-Appalaches
2413 Laval
2414 Lanaudière
2415 Laurentides
2416 Montérégie
4.6
3.9
2.2
5.1
4.0
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
13.0
13.1
13.2
11.6
13.2
14.2
12.8
12.5
13.5
14.7
15.0
13.0
12.6
12.0
13.1
13.0
(12.9–13.2)
(12.4–13.8)
(12.6–13.9)
(11.1–12.1)
(12.6–13.7)
(13.6–14.8)
(12.5–13.1)
(11.7–13.2)
(12.6–14.4)
(13.6–15.8)
(14.2–15.9)
(12.4–13.6)
(11.9–13.3)
(11.4–12.7)
(12.5–13.7)
(12.7–13.3)
Ontario
3501 Erie St. Clair
3502 South West
3503 Waterloo Wellington
3504 Hamilton Niagara Haldimand Brant
3505 Central West
3506 Mississauga Halton
3507 Toronto Central
3508 Central
3509 Central East
3510 South East
3511 Champlain
3512 North Simcoe Muskoka
3513 North East
3514 North West
4.0
4.9
3.8
3.9
3.6
4.1
3.0
4.1
3.6
3.8
4.1
3.0
3.3
6.7
5.6
(3.9–4.2)
(4.2–5.7)
(3.2–4.4)
(3.1–4.7)
(3.0–4.1)
(3.3–4.9)
(2.2–3.7)
(3.3–4.8)
(3.0–4.3)
(3.3–4.4)
(3.3–4.9)
(2.4–3.6)
(2.4–4.2)
(6.0–7.3)
(4.5–6.6)
13.3
12.8
13.7
12.0
12.9
12.6
12.2
14.3
13.3
12.8
12.7
13.6
13.4
14.7
15.1
(13.2–13.4)
(12.4–13.3)
(13.3–14.1)
(11.5–12.6)
(12.6–13.3)
(12.0–13.1)
(11.7–12.6)
(13.9–14.7)
(13.0–13.7)
(12.4–13.1)
(12.1–13.2)
(13.2–14.0)
(12.8–13.9)
(14.3–15.2)
(14.5–15.7)
Manitoba
4610 Winnipeg
4615 Brandon
4625 South Eastman
4630 Interlake
4640 Central
4645 Assiniboine
4.7
3.2
*
*
6.8
6.6
5.6
(4.1–5.3)
(2.4–4.0)
**
**
(5.0–8.7)
(4.8–8.4)
(3.5–7.7)
13.7
11.7
11.3
14.1
15.4
15.1
15.0
(13.3–14.0)
(11.1–12.2)
(9.5–13.1)
(12.5–15.7)
(14.3–16.6)
(14.0–16.2)
(13.9–16.1)
Newfoundland and Labrador
1011 Eastern
1012 Central
1013 Western
Scotia
South Shore
South West Nova
Annapolis Valley
Colchester East Hants
Cape Breton
Capital
New Brunswick
1301 Zone 1 (Moncton area)
1302 Zone 2 (Saint John area)
1303 Zone 3 (Fredericton area)
1306 Zone 6 (Bathurst area)
76
Risk-Adjusted Rate (%)
95% CI
30-Day Medical Readmission
2010 –2011
Health System Performance
Acute Myocardial Infarction Readmission
2008–2009 to 2010 –2011
30-Day Medical Readmission
2010 –2011
Map
Code Health Region
Risk-Adjusted Rate (%)
Risk-Adjusted Rate (%)
95% CI
Saskatchewan
4701 Sun Country
4702 Five Hills
4704 Regina
4705 Sunrise
4706 Saskatoon
4709 Prince Albert
4710 Prairie North
4.6
*
*
3.2
5.2
4.1
4.5
5.9
(4.0–5.2)
**
**
(1.9–4.6)
(2.7–7.6)
(2.9–5.3)
(2.5–6.6)
(3.6–8.2)
15.1
15.3
14.6
14.9
17.6
14.8
12.9
14.1
(14.8–15.4)
(14.0–16.5)
(13.2–15.9)
(14.3–15.6)
(16.7–18.6)
(14.1–15.5)
(11.6–14.2)
(12.8–15.4)
Alberta
4831 South Zone
4832 Calgary Zone
4833 Central Zone
4834 Edmonton Zone
4835 North Zone
3.1
3.4
3.2
3.8
2.1
4.1
(2.7–3.5)
(2.2–4.6)
(2.5–3.9)
(2.9–4.8)
(1.4–2.8)
(3.0–5.2)
13.0
13.2
11.7
14.2
12.2
14.6
(12.7–13.2)
(12.5–13.9)
(11.3–12.2)
(13.7–14.7)
(11.8–12.6)
(14.1–15.2)
British Columbia
5911 East Kootenay
5912 Kootenay Boundary
5913 Okanagan
5914 Thompson/Cariboo/Shuswap
5921 Fraser East
5922 Fraser North
5923 Fraser South
5931 Richmond
5932 Vancouver
5933 North Shore
5941 South Vancouver Island
5942 Central Vancouver Island
5943 North Vancouver Island
5951 Northwest
5952 Northern Interior
5953 Northeast
3.8
3.9
5.7
4.4
4.3
4.2
3.5
4.0
2.9
2.8
2.5
2.4
3.8
4.5
*
4.6
*
(3.4–4.1)
(2.1–5.8)
(3.9–7.5)
(3.5–5.4)
(3.1–5.6)
(2.9–5.5)
(2.4–4.7)
(3.1–4.9)
(0.8–5.0)
(1.8–3.9)
(1.2–3.8)
(1.1–3.6)
(2.7–5.0)
(2.6–6.4)
**
(2.9–6.4)
**
14.1
14.4
14.0
14.1
14.6
14.5
14.7
13.8
14.8
14.5
14.5
11.4
13.5
13.9
15.9
14.9
15.0
(14.0–14.3)
(13.2–15.7)
(12.6–15.3)
(13.6–14.7)
(13.8–15.4)
(13.8–15.2)
(14.1–15.3)
(13.3–14.3)
(13.7–15.9)
(14.0–15.1)
(13.7–15.2)
(10.7–12.1)
(12.8–14.2)
(12.8–15.0)
(14.6–17.1)
(13.9–15.8)
(13.4–16.7)
Yukon
*
**
13.4
(11.4–15.5)
Northwest Territories
*
**
14.6
(12.8–16.3)
*
**
15.4
(13.1–17.7)
Nunavut
Canada
4.1
95% CI
13.4
Acute myocardial infarction readmission
The risk-adjusted rate of unplanned readmission following discharge for acute myocardial infarction (AMI, or heart attack). Rates are based
on three years of pooled data.
Note: Rates for Quebec are not available due to differences in data collection; the Canada rate does not include Quebec.
Sources: Discharge Abstract Database and National Ambulatory Care Reporting System, Canadian Institute for Health Information; Alberta Ambulatory Care
Reporting System, Alberta Health and Wellness.
30-day medical readmission
Risk-adjusted rate of unplanned readmission for adult medical patient group. Non-elective return to an acute care hospital for any cause is
counted as a readmission if it occurs within 30 days of discharge from the index episode of inpatient care. Urgent, unplanned readmissions
to acute care facilities are increasingly being used to measure institutional or regional quality of care and care coordination. While not all
unplanned readmissions are avoidable, interventions during and after a hospitalization can be effective in reducing readmission rates.
Sources: Discharge Abstract Database and National Ambulatory Care Reporting System, Canadian Institute for Health Information; Fichier des
hospitalisations MED-ÉCHO, ministère de la Santé et des Services sociaux du Québec.
77
Health Indicators 2012
30-Day Surgical Readmission
2010 –2011
Map
Code Health Region
Newfoundland and Labrador
1011 Eastern
1012 Central
1013 Western
30-Day Obstetric Readmission
2010 –2011
Risk-Adjusted Rate (%)
95% CI
Risk-Adjusted Rate (%)
95% CI
6.3
6.3
6.4
6.1
(5.8–6.7)
(5.8–6.9)
(5.4–7.3)
(5.0–7.2)
2.7
2.9
2.7
2.5
(2.4–3.1)
(2.4–3.3)
(1.9–3.5)
(1.5–3.5)
Prince Edward Island
6.1
(5.2–6.9)
2.1
(1.4–2.8)
Nova
1211
1212
1223
1234
1258
1269
6.2
4.9
5.8
5.4
5.5
6.2
6.7
(5.9–6.5)
(3.8–6.1)
(4.5–7.0)
(4.3–6.4)
(4.4–6.6)
(5.4–7.0)
(6.2–7.2)
2.3
2.9
1.3
4.0
2.1
2.4
2.2
(2.0–2.5)
(1.6–4.1)
(0.0–2.5)
(3.2–4.9)
(1.3–2.9)
(1.6–3.3)
(1.8–2.5)
New Brunswick
1301 Zone 1 (Moncton area)
1302 Zone 2 (Saint John area)
1303 Zone 3 (Fredericton area)
1306 Zone 6 (Bathurst area)
6.4
6.6
6.6
7.4
5.4
(6.1–6.7)
(5.9–7.2)
(5.9–7.2)
(6.6–8.1)
(4.5–6.3)
2.2
2.2
1.9
2.1
2.4
(1.9–2.5)
(1.6–2.9)
(1.3–2.6)
(1.5–2.8)
(1.4–3.5)
Quebec
2401 Bas-Saint-Laurent
2402 Saguenay–Lac-Saint-Jean
2403 Capitale-Nationale
2404 Mauricie et Centre-du-Québec
2405 Estrie
2406 Montréal
2407 Outaouais
2408 Abitibi-Témiscamingue
2409 Côte-Nord
2411 Gaspésie–Îles-de-la-Madeleine
2412 Chaudière-Appalaches
2413 Laval
2414 Lanaudière
2415 Laurentides
2416 Montérégie
6.1
6.1
6.2
5.6
6.6
6.8
6.1
5.2
7.2
7.8
7.7
6.0
6.0
5.5
5.7
5.9
(6.0–6.2)
(5.5–6.8)
(5.6–6.8)
(5.2–6.0)
(6.1–7.0)
(6.3–7.3)
(5.8–6.3)
(4.6–5.8)
(6.3–8.0)
(6.8–8.8)
(6.9–8.6)
(5.5–6.5)
(5.5–6.6)
(5.0–6.0)
(5.3–6.2)
(5.7–6.2)
2.0
1.9
2.4
1.9
1.6
1.2
2.2
1.5
1.2
3.1
1.9
1.6
2.2
1.8
2.5
2.0
(1.9–2.1)
(1.2–2.7)
(1.8–2.9)
(1.5–2.3)
(1.1–2.0)
(0.6–1.8)
(2.0–2.4)
(1.1–2.0)
(0.5–1.9)
(2.2–3.9)
(0.9–2.8)
(1.1–2.1)
(1.7–2.7)
(1.3–2.2)
(2.0–2.9)
(1.8–2.2)
Ontario
3501 Erie St. Clair
3502 South West
3503 Waterloo Wellington
3504 Hamilton Niagara Haldimand Brant
3505 Central West
3506 Mississauga Halton
3507 Toronto Central
3508 Central
3509 Central East
3510 South East
3511 Champlain
3512 North Simcoe Muskoka
3513 North East
3514 North West
6.6
6.3
6.9
5.7
6.5
6.7
6.3
7.4
6.4
5.9
6.7
6.9
6.8
7.5
7.9
(6.5–6.7)
(5.9–6.7)
(6.5–7.2)
(5.3–6.2)
(6.2–6.8)
(6.2–7.1)
(5.9–6.7)
(7.0–7.7)
(6.1–6.7)
(5.6–6.2)
(6.2–7.1)
(6.5–7.2)
(6.3–7.3)
(7.1–7.8)
(7.3–8.5)
1.8
0.9
1.9
1.8
1.7
1.8
1.5
2.5
1.7
1.8
2.3
1.9
1.5
1.6
2.5
(1.7–1.9)
(0.6–1.2)
(1.6–2.2)
(1.5–2.1)
(1.4–1.9)
(1.5–2.1)
(1.3–1.8)
(2.2–2.7)
(1.5–1.9)
(1.6–2.0)
(1.9–2.8)
(1.6–2.1)
(1.0–1.9)
(1.2–1.9)
(2.0–2.9)
Manitoba
4610 Winnipeg
4615 Brandon
4625 South Eastman
4630 Interlake
4640 Central
4645 Assiniboine
6.2
5.5
6.6
6.7
6.4
7.2
6.9
(5.9–6.5)
(5.1–5.9)
(5.2–8.0)
(5.3–8.0)
(5.3–7.5)
(6.2–8.2)
(5.8–8.0)
2.4
2.6
1.1
2.5
2.3
2.6
1.8
(2.2–2.5)
(2.3–2.9)
(0.0–2.2)
(2.0–3.1)
(1.4–3.1)
(2.1–3.2)
(0.9–2.7)
78
Scotia
South Shore
South West Nova
Annapolis Valley
Colchester East Hants
Cape Breton
Capital
Health System Performance
30-Day Surgical Readmission
2010 –2011
30-Day Obstetric Readmission
2010 –2011
Map
Code Health Region
Risk-Adjusted Rate (%)
95% CI
Risk-Adjusted Rate (%)
95% CI
Saskatchewan
4701 Sun Country
4702 Five Hills
4704 Regina
4705 Sunrise
4706 Saskatoon
4709 Prince Albert
4710 Prairie North
7.5
7.2
7.7
7.3
8.7
6.5
7.3
7.8
(7.2–7.8)
(5.9–8.4)
(6.5–8.9)
(6.7–7.9)
(7.6–9.8)
(5.9–7.1)
(6.1–8.5)
(6.6–9.0)
2.2
3.5
*
2.1
3.1
2.1
1.9
2.5
(2.0–2.4)
(2.6–4.4)
**
(1.7–2.6)
(2.1–4.1)
(1.6–2.5)
(1.1–2.6)
(1.9–3.1)
Alberta
4831 South Zone
4832 Calgary Zone
4833 Central Zone
4834 Edmonton Zone
4835 North Zone
6.4
6.7
5.8
7.1
6.5
7.2
(6.3–6.6)
(6.1–7.4)
(5.5–6.2)
(6.6–7.5)
(6.1–6.8)
(6.7–7.8)
1.8
1.6
1.8
1.5
2.0
2.1
(1.7–2.0)
(1.1–2.0)
(1.6–2.0)
(1.2–1.8)
(1.8–2.2)
(1.8–2.3)
British Columbia
5911 East Kootenay
5912 Kootenay Boundary
5913 Okanagan
5914 Thompson/Cariboo/Shuswap
5921 Fraser East
5922 Fraser North
5923 Fraser South
5931 Richmond
5932 Vancouver
5933 North Shore
5941 South Vancouver Island
5942 Central Vancouver Island
5943 North Vancouver Island
5951 Northwest
5952 Northern Interior
5953 Northeast
7.0
7.1
7.2
7.9
6.9
7.8
7.0
6.6
6.7
7.0
7.1
5.7
7.3
6.5
8.3
6.9
6.5
(6.8–7.1)
(6.0–8.2)
(6.1–8.2)
(7.5–8.4)
(6.2–7.6)
(7.2–8.5)
(6.5–7.4)
(6.1–7.0)
(5.8–7.5)
(6.6–7.5)
(6.5–7.8)
(5.2–6.2)
(6.8–7.9)
(5.6–7.4)
(7.2–9.5)
(6.1–7.8)
(5.0–8.0)
2.4
2.5
3.4
2.4
2.1
2.4
2.5
2.4
2.3
2.5
2.1
2.0
2.7
2.9
2.4
2.2
1.7
(2.3–2.5)
(1.6–3.3)
(2.4–4.3)
(1.9–2.8)
(1.5–2.7)
(1.9–2.8)
(2.2–2.7)
(2.1–2.7)
(1.6–3.1)
(2.2–2.9)
(1.5–2.7)
(1.6–2.5)
(2.2–3.3)
(2.2–3.7)
(1.5–3.2)
(1.6–2.9)
(0.8–2.6)
Yukon
7.7
(5.7–9.6)
2.6
(1.3–3.8)
Northwest Territories
9.0
(7.2–10.8)
1.5
(0.6–2.4)
Nunavut
7.6
(5.2–9.9)
1.0
(0.3–1.6)
Canada
6.5
2.0
30-day surgical readmission
Risk-adjusted rate of unplanned readmission for adult surgical patient group. Non-elective return to an acute care hospital for any cause is
counted as a readmission if it occurs within 30 days of discharge from the index episode of inpatient care. Urgent, unplanned readmissions
to acute care facilities are increasingly being used to measure institutional or regional quality of care and care coordination. While not all
unplanned readmissions are avoidable, interventions during and after a hospitalization can be effective in reducing readmission rates.
Sources: Discharge Abstract Database and National Ambulatory Care Reporting System, Canadian Institute for Health Information; Fichier des
hospitalisations MED-ÉCHO, ministère de la Santé et des Services sociaux du Québec.
30-day obstetric readmission
Risk-adjusted rate of unplanned readmission for obstetric patient group. Non-elective return to an acute care hospital for any cause is
counted as a readmission if it occurs within 30 days of discharge from the index episode of inpatient care. Urgent, unplanned readmissions
to acute care facilities are increasingly being used to measure institutional or regional quality of care and care coordination. While not all
unplanned readmissions are avoidable, interventions during and after a hospitalization can be effective in reducing readmission rates.
Sources: Discharge Abstract Database and National Ambulatory Care Reporting System, Canadian Institute for Health Information; Fichier des
hospitalisations MED-ÉCHO, ministère de la Santé et des Services sociaux du Québec.
79
Health Indicators 2012
30-Day Pediatric Readmission
2010 –2011
Map
Code
Risk-Adjusted Rate (%)
95% CI
Risk-Adjusted Rate (%)
95% CI
Newfoundland and Labrador
1011 Eastern
1012 Central
1013 Western
6.7
6.5
9.1
4.7
(5.8–7.5)
(5.4–7.6)
(7.0–11.2)
(2.1–7.3)
11.0
7.7
10.7
14.1
(9.4–12.7)
(4.7–10.8)
(6.4–15.1)
(11.4–16.7)
Prince Edward Island
8.7
(7.2–10.1)
12.3
(10.2–14.4)
7.7
10.8
7.7
6.2
6.0
8.1
8.0
(7.0–8.4)
(7.9–13.7)
(4.9–10.5)
(3.7–8.6)
(3.7–8.3)
(6.5–9.7)
(6.9–9.0)
11.8
16.5
8.1
26.4
9.6
11.3
10.7
(10.5–13.0)
(10.1–22.8)
(4.1–12.1)
(21.4–31.4)
(4.0–15.3)
(8.7–13.9)
(8.5–13.0)
New Brunswick
1301 Zone 1 (Moncton area)
1302 Zone 2 (Saint John area)
1303 Zone 3 (Fredericton area)
1306 Zone 6 (Bathurst area)
6.0
7.0
5.6
5.0
5.8
(5.4–6.6)
(5.8–8.1)
(4.2–7.0)
(3.5–6.5)
(4.0–7.5)
11.0
10.1
6.9
9.3
13.0
(9.9–12.1)
(7.7–12.4)
(3.3–10.5)
(6.4–12.1)
(10.1–15.8)
Quebec
2401 Bas-Saint-Laurent
2402 Saguenay–Lac-Saint-Jean
2403 Capitale-Nationale
2404 Mauricie et Centre-du-Québec
2405 Estrie
2406 Montréal
2407 Outaouais
2408 Abitibi-Témiscamingue
2409 Côte-Nord
2411 Gaspésie–Îles-de-la-Madeleine
2412 Chaudière-Appalaches
2413 Laval
2414 Lanaudière
2415 Laurentides
2416 Montérégie
6.4
5.0
7.8
7.0
5.9
5.9
6.4
5.7
5.8
4.4
7.7
6.7
7.2
6.2
5.3
6.5
(6.2–6.6)
(3.5–6.4)
(6.9–8.8)
(6.3–7.7)
(5.1–6.7)
(4.8–7.1)
(5.9–7.0)
(4.6–6.7)
(4.6–7.0)
(2.7–6.0)
(6.0–9.5)
(5.8–7.6)
(6.1–8.3)
(5.3–7.0)
(4.4–6.1)
(6.0–7.0)
11.2
13.4
12.9
8.6
13.3
13.4
8.7
8.9
13.0
7.9
9.7
11.9
9.6
13.5
9.2
11.3
(10.8–11.5)
(11.4–15.4)
(11.4–14.5)
(7.0–10.1)
(12.0–14.5)
(11.8–15.0)
(7.7–9.8)
(6.9–11.0)
(10.6–15.4)
(4.8–10.9)
(6.6–12.8)
(10.5–13.2)
(7.4–11.8)
(12.0–15.0)
(7.7–10.8)
(10.4–12.2)
Ontario
3501 Erie St. Clair
3502 South West
3503 Waterloo Wellington
3504 Hamilton Niagara Haldimand Brant
3505 Central West
3506 Mississauga Halton
3507 Toronto Central
3508 Central
3509 Central East
3510 South East
3511 Champlain
3512 North Simcoe Muskoka
3513 North East
3514 North West
7.0
7.3
7.7
6.9
6.8
6.9
7.1
7.2
7.0
6.9
6.5
6.1
7.2
7.0
7.8
(6.8–7.1)
(6.5–8.1)
(7.1–8.4)
(6.1–7.6)
(6.3–7.3)
(6.2–7.5)
(6.5–7.7)
(6.5–7.9)
(6.5–7.5)
(6.3–7.4)
(5.4–7.6)
(5.4–6.7)
(6.2–8.3)
(6.2–7.8)
(6.8–8.8)
11.5
8.5
10.4
11.5
10.7
10.7
10.5
13.3
11.8
11.2
11.2
10.9
9.7
14.5
12.6
(11.2–11.8)
(7.0–10.0)
(9.1–11.6)
(10.1–12.9)
(9.7–11.6)
(9.3–12.1)
(9.1–11.8)
(12.3–14.3)
(10.8–12.8)
(10.2–12.1)
(9.5–12.8)
(9.9–12.0)
(8.1–11.2)
(13.5–15.5)
(11.0–14.2)
Manitoba
4610 Winnipeg
4615 Brandon
4625 South Eastman
4630 Interlake
4640 Central
4645 Assiniboine
6.9
6.4
6.5
6.2
5.2
6.4
8.8
(6.3–7.4)
(5.5–7.3)
(3.7–9.2)
(4.1–8.3)
(3.1–7.4)
(4.7–8.1)
(6.7–10.9)
8.9
8.3
10.2
9.3
5.8
11.7
12.8
(7.9–9.8)
(7.0–9.7)
(6.3–14.0)
(3.3–15.2)
(1.0–10.6)
(7.2–16.1)
(9.2–16.5)
Nova
1211
1212
1223
1234
1258
1269
80
Health Region
30-Day Readmission for Mental Illness
2010 –2011
Scotia
South Shore
South West Nova
Annapolis Valley
Colchester East Hants
Cape Breton
Capital
Health System Performance
30-Day Pediatric Readmission
2010 –2011
Map
Code
Health Region
30-Day Readmission for Mental Illness
2010 –2011
Risk-Adjusted Rate (%)
95% CI
Risk-Adjusted Rate (%)
95% CI
Saskatchewan
4701 Sun Country
4702 Five Hills
4704 Regina
4705 Sunrise
4706 Saskatoon
4709 Prince Albert
4710 Prairie North
7.5
4.8
7.5
7.4
6.0
7.7
8.4
6.3
(7.0–7.9)
(2.7–7.0)
(5.9–9.0)
(6.6–8.3)
(4.2–7.7)
(6.7–8.8)
(7.0–9.7)
(4.8–7.7)
10.5
8.1
11.4
10.1
11.6
8.4
12.4
9.6
(9.6–11.4)
(3.4–12.8)
(7.9–14.9)
(8.2–12.1)
(7.7–15.6)
(6.1–10.7)
(9.5–15.3)
(6.6–12.7)
Alberta
4831 South Zone
4832 Calgary Zone
4833 Central Zone
4834 Edmonton Zone
4835 North Zone
6.1
6.1
5.8
6.0
6.0
6.8
(5.8–6.4)
(5.1–7.1)
(5.3–6.4)
(5.2–6.8)
(5.4–6.6)
(6.1–7.5)
9.7
10.1
9.3
9.2
8.4
12.3
(9.1–10.3)
(8.5–11.7)
(8.3–10.3)
(7.4–11.0)
(7.2–9.7)
(10.9–13.7)
British Columbia
5911 East Kootenay
5912 Kootenay Boundary
5913 Okanagan
5914 Thompson/Cariboo/Shuswap
5921 Fraser East
5922 Fraser North
5923 Fraser South
5931 Richmond
5932 Vancouver
5933 North Shore
5941 South Vancouver Island
5942 Central Vancouver Island
5943 North Vancouver Island
5951 Northwest
5952 Northern Interior
5953 Northeast
6.1
3.6
5.4
6.0
6.1
6.0
5.8
6.5
5.9
6.0
5.6
6.1
6.4
5.1
7.8
5.9
5.5
(5.7–6.4)
(1.5–5.7)
(2.8–8.0)
(4.9–7.2)
(4.7–7.6)
(4.8–7.1)
(4.8–6.9)
(5.8–7.3)
(4.0–7.8)
(4.9–7.1)
(4.2–7.0)
(5.0–7.2)
(5.1–7.7)
(2.9–7.3)
(6.0–9.7)
(4.5–7.4)
(3.1–7.9)
13.0
15.0
16.7
14.0
12.3
13.1
12.8
12.0
15.7
13.4
13.9
12.4
12.2
11.9
10.2
12.3
12.1
(12.6–13.5)
(12.2–17.9)
(13.8–19.5)
(12.6–15.5)
(10.4–14.2)
(11.4–14.8)
(11.5–14.1)
(10.8–13.2)
(13.4–18.1)
(12.4–14.5)
(12.0–15.8)
(10.8–14.0)
(10.3–14.0)
(8.6–15.2)
(7.7–12.8)
(10.3–14.2)
(9.0–15.1)
(5.9–14.2)
Yukon
4.1
(0.4–7.7)
10.0
Northwest Territories
8.1
(5.9–10.3)
11.8
(9.1–14.5)
Nunavut
7.2
(5.4–9.0)
10.2
(5.6–14.9)
Canada
6.7
11.4
30-day pediatric readmission
Risk-adjusted rate of unplanned readmission for pediatric patient group. Non-elective return to an acute care hospital for any cause is
counted as a readmission if it occurs within 30 days of discharge from the index episode of inpatient care. Urgent, unplanned readmissions
to acute care facilities are increasingly being used to measure institutional or regional quality of care and care coordination. While not all
unplanned readmissions are avoidable, interventions during and after a hospitalization can be effective in reducing readmission rates.
Sources: Discharge Abstract Database and National Ambulatory Care Reporting System, Canadian Institute for Health Information; Fichier des
hospitalisations MED-ÉCHO, ministère de la Santé et des Services sociaux du Québec.
30-day readmission for mental illness
Risk-adjusted rate of readmission following discharge for a mental illness. A case is counted as a readmission in a general hospital if it is for
a selected mental illness diagnosis and if it occurs within 30 days of discharge from the index episode of inpatient care. High rates of 30-day
readmission could be interpreted as being a direct outcome of poor coordination of services and/or an indirect outcome of poor continuity of
services after discharge.
Sources: Discharge Abstract Database, National Ambulatory Care Reporting System and Ontario Mental Health Reporting System, Canadian Institute for
Health Information; Fichier des hospitalisations MED-ÉCHO, ministère de la Santé et des Services sociaux du Québec.
81
Health Indicators 2012
Patients With Repeat Hospitalizations
for Mental Illness
2009 –2010
Map
Code
2010 –2011
Age-Standardized Rate
per 100,000
Risk-Adjusted Rate (%)
95% CI
Newfoundland and Labrador
1011 Eastern
1012 Central
1013 Western
12.0
9.8
11.2
15.7
(10.2–13.8)
(6.6–13.0)
(7.5–15.0)
(12.4–18.9)
83
71
78
123
Prince Edward Island
12.2
(9.9–14.5)
44
(32–57)
Nova
1211
1212
1223
1234
1258
1269
10.0
8.6
10.2
6.8
4.6
12.6
8.7
(8.6–11.3)
(2.7–14.6)
(5.5–14.9)
(0.8–12.7)
(2.0–10.2)
(9.8–15.4)
(6.4–11.0)
60
34
74
40
70
101
53
(55–66)
(16–52)
(44–104)
(23–57)
(47–93)
(77–125)
(45–61)
New Brunswick
1301 Zone 1 (Moncton area)
1302 Zone 2 (Saint John area)
1303 Zone 3 (Fredericton area)
1306 Zone 6 (Bathurst area)
10.4
8.4
3.8
9.5
13.5
(9.2–11.5)
(6.1–10.8)
(0.2–7.3)
(6.6–12.3)
(10.3–16.6)
77
51
88
68
73
(69–84)
(40–62)
(71–105)
(53–82)
(49–97)
Quebec
2401 Bas-Saint-Laurent
2402 Saguenay–Lac-Saint-Jean
2403 Capitale-Nationale
2404 Mauricie et Centre-du-Québec
2405 Estrie
2406 Montréal
2407 Outaouais
2408 Abitibi-Témiscamingue
2409 Côte-Nord
2411 Gaspésie–Îles-de-la-Madeleine
2412 Chaudière-Appalaches
2413 Laval
2414 Lanaudière
2415 Laurentides
2416 Montérégie
10.2
13.0
12.9
6.6
14.0
10.4
8.2
6.2
11.9
10.4
11.0
12.5
9.0
10.4
8.7
10.5
(9.7–10.6)
(10.8–15.1)
(11.1–14.8)
(5.1–8.0)
(12.6–15.4)
(8.5–12.2)
(7.2–9.2)
(4.1–8.3)
(9.1–14.7)
(7.4–13.3)
(7.8–14.2)
(10.9–14.0)
(6.7–11.2)
(8.7–12.0)
(7.1–10.3)
(9.6–11.5)
58
78
90
60
91
80
23
66
118
83
127
98
18
62
59
62
(56–60)
(63–93)
(76–104)
(53–66)
(81–101)
(68–92)
(20–25)
(57–76)
(97–139)
(61–105)
(97–157)
(86–109)
(13–23)
(53–70)
(52–67)
(57–67)
Ontario
3501 Erie St. Clair
3502 South West
3503 Waterloo Wellington
3504 Hamilton Niagara Haldimand Brant
3505 Central West
3506 Mississauga Halton
3507 Toronto Central
3508 Central
3509 Central East
3510 South East
3511 Champlain
3512 North Simcoe Muskoka
3513 North East
3514 North West
10.5
8.3
9.8
9.8
9.4
9.5
10.9
13.5
10.4
11.0
8.4
10.2
9.1
12.6
10.8
(10.2–10.9)
(6.8–9.9)
(8.5–11.1)
(8.2–11.4)
(8.4–10.5)
(8.0–11.0)
(9.5–12.3)
(12.3–14.6)
(9.2–11.5)
(9.9–12.1)
(6.6–10.2)
(9.0–11.3)
(7.4–10.8)
(11.5–13.8)
(9.0–12.6)
63
60
68
74
74
49
38
50
38
48
72
52
132
160
188
(62–65)
(53–67)
(62–74)
(67–81)
(69–79)
(43–54)
(34–42)
(46–55)
(35–41)
(44–52)
(63–81)
(48–57)
(120–145)
(147–173)
(167–210)
Manitoba
4610 Winnipeg
4615 Brandon
4625 South Eastman
4630 Interlake
4640 Central
4645 Assiniboine
9.7
9.0
11.2
6.0
5.8
7.5
11.7
(8.7–10.7)
(7.7–10.3)
(7.0–15.3)
(0.4–11.6)
(1.4–10.3)
(2.9–12.2)
(7.8–15.7)
58
43
73
41
40
34
50
(53–63)
(37–48)
(46–100)
(23–59)
(24–56)
(20–47)
(28–72)
82
Health Region
Self-Injury Hospitalization
Scotia
South Shore
South West Nova
Annapolis Valley
Colchester East Hants
Cape Breton
Capital
95% CI
(74–93)
(59–82)
(54–102)
(92–154)
Health System Performance
Patients With Repeat Hospitalizations
for Mental Illness
2009 –2010
Map
Code
Health Region
Self-Injury Hospitalization
2010 –2011
Age-Standardized Rate
per 100,000
Risk-Adjusted Rate (%)
95% CI
Saskatchewan
4701 Sun Country
4702 Five Hills
4704 Regina
4705 Sunrise
4706 Saskatoon
4709 Prince Albert
4710 Prairie North
11.2
12.8
17.9
10.1
14.2
7.8
12.1
12.6
(10.2–12.3)
(6.7–18.8)
(13.8–22.0)
(8.0–12.3)
(10.0–18.4)
(5.6–10.1)
(8.8–15.4)
(9.2–16.0)
85
88
76
71
78
62
66
174
(78–91)
(57–119)
(47–105)
(59–82)
(46–109)
(52–72)
(43–88)
(137–212)
Alberta
4831 South Zone
4832 Calgary Zone
4833 Central Zone
4834 Edmonton Zone
4835 North Zone
9.6
13.5
10.5
7.3
8.4
9.0
(9.0–10.2)
(11.7–15.3)
(9.4–11.5)
(5.5–9.0)
(7.3–9.6)
(7.4–10.7)
60
101
40
68
59
99
(58–63)
(87–114)
(36–43)
(59–76)
(54–63)
(88–109)
British Columbia
5911 East Kootenay
5912 Kootenay Boundary
5913 Okanagan
5914 Thompson/Cariboo/Shuswap
5921 Fraser East
5922 Fraser North
5923 Fraser South
5931 Richmond
5932 Vancouver
5933 North Shore
5941 South Vancouver Island
5942 Central Vancouver Island
5943 North Vancouver Island
5951 Northwest
5952 Northern Interior
5953 Northeast
12.7
12.8
8.6
13.2
13.0
13.0
12.9
12.7
12.4
13.7
14.1
10.6
11.3
6.0
17.9
12.9
11.2
(12.2–13.2)
(9.4–16.2)
(5.4–11.8)
(11.6–14.8)
(10.9–15.1)
(11.2–14.7)
(11.4–14.4)
(11.4–14.1)
(9.4–15.3)
(12.5–15.0)
(12.0–16.2)
(8.8–12.4)
(9.2–13.4)
(2.6–9.3)
(14.8–20.9)
(10.8–15.1)
(7.9–14.5)
76
87
74
120
105
91
54
79
44
44
59
70
120
95
210
122
43
(73–79)
(63–112)
(50–98)
(106–134)
(88–122)
(78–103)
(47–61)
(71–86)
(34–54)
(38–50)
(48–69)
(60–80)
(103–136)
(73–117)
(168–252)
(100–143)
(25–61)
Yukon
95% CI
4.7
(2.0–10.5)
178
(127–229)
13.3
(9.8–16.7)
260
(207–314)
Nunavut
7.4
(2.9–12.0)
296
(231–360)
Canada
10.8
66
(65–67)
Northwest Territories
Patients with repeat hospitalizations for mental illness
Risk-adjusted percentage of individuals who had three or more episodes of care for a selected mental illness over all those who had at least
one episode of care for a selected mental illness in general hospitals within a given year. This indicator is considered an indirect measure
of appropriateness of care. Variations in this indicator across jurisdictions may reflect differences in the services that help individuals with
mental illness remain in the community for a longer period of time without the need for hospitalization.
Sources: Discharge Abstract Database, National Ambulatory Care Reporting System and Ontario Mental Health Reporting System, Canadian Institute for
Health Information; Fichier des hospitalisations MED-ÉCHO, ministère de la Santé et des Services sociaux du Québec.
Self-injury hospitalization
Age-standardized rate of hospitalization in a general hospital due to self-injury, per 100,000 population age 15 and older. Self-injuries may
be the result of suicidal and/or self-harming behaviours. In many cases, they can be prevented by early recognition of, intervention for and
treatment of mental illnesses. While some risk factors are beyond the control of the health system, high rates of self-injury hospitalization
could be interpreted as being the result of the system’s failure to prevent self-injuries that are severe enough to require hospitalization.
Sources: Discharge Abstract Database, National Ambulatory Care Reporting System and Ontario Mental Health Reporting System, Canadian Institute
for Health Information; Fichier des hospitalisations MED-ÉCHO, ministère de la Santé et des Services sociaux du Québec.
83
Health Indicators 2012
Mental Illness Hospitalization
2010 –2011
Mental Illness Patient Days
2010 –2011
Age-Standardized
Rate per 100,000
95% CI
Newfoundland and Labrador
1011 Eastern
1012 Central
1013 Western
417
188
560
916
(388–445)
(167–209)
(476–645)
(793–1,040)
492
242
714
1,322
(443–541)
(206–279)
(577–851)
(1,056–1,588)
Prince Edward Island
870
(794–947)
884
(780–989)
Nova
1211
1212
1223
1234
1258
1269
379
295
634
275
304
662
262
(360–399)
(229–361)
(530–738)
(180–369)
(246–362)
(587–737)
(241–284)
607
573
692
251
447
1,129
555
(544–670)
(384–762)
(538–846)
(176–325)
(315–579)
(913–1,345)
(451–658)
New Brunswick
1301 Zone 1 (Moncton area)
1302 Zone 2 (Saint John area)
1303 Zone 3 (Fredericton area)
1306 Zone 6 (Bathurst area)
588
487
285
419
831
(562–615)
(443–530)
(252–319)
(376–461)
(723–938)
834
731
736
546
1,202
(763–906)
(638–824)
(516–956)
(467–626)
(991–1,412)
Quebec
2401 Bas-Saint-Laurent
2402 Saguenay–Lac-Saint-Jean
2403 Capitale-Nationale
2404 Mauricie et Centre-du-Québec
2405 Estrie
2406 Montréal
2407 Outaouais
2408 Abitibi-Témiscamingue
2409 Côte-Nord
2411 Gaspésie–Îles-de-la-Madeleine
2412 Chaudière-Appalaches
2413 Laval
2414 Lanaudière
2415 Laurentides
2416 Montérégie
435
707
807
329
649
655
252
387
627
728
675
684
274
504
392
474
(428–442)
(641–773)
(746–869)
(310–348)
(610–687)
(607–703)
(242–261)
(358–415)
(558–696)
(649–806)
(586–764)
(643–724)
(251–298)
(468–539)
(366–417)
(456–492)
894
1,060
1,191
743
991
1,447
811
540
837
1,797
921
1,132
843
905
936
888
(867–922)
(919–1,202)
(1,061–1,321)
(673–813)
(869–1,113)
(1,292–1,603)
(747–874)
(483–596)
(638–1,036)
(1,020–2,575)
(712–1,131)
(1,025–1,238)
(721–965)
(802–1,009)
(830–1,042)
(828–947)
Ontario
3501 Erie St. Clair
3502 South West
3503 Waterloo Wellington
3504 Hamilton Niagara Haldimand Brant
3505 Central West
3506 Mississauga Halton
3507 Toronto Central
3508 Central
3509 Central East
3510 South East
3511 Champlain
3512 North Simcoe Muskoka
3513 North East
3514 North West
409
390
414
393
463
338
275
394
292
367
385
385
556
976
865
(403–414)
(367–414)
(394–433)
(370–415)
(446–481)
(319–357)
(261–289)
(376–412)
(280–304)
(352–381)
(358–412)
(367–402)
(522–590)
(927–1,025)
(799–932)
485
651
489
380
489
374
348
514
360
443
447
493
434
1,203
914
(475–496)
(580–723)
(456–523)
(348–411)
(461–517)
(345–402)
(319–377)
(481–546)
(338–381)
(405–481)
(405–489)
(462–524)
(397–472)
(1,108–1,298)
(760–1,067)
Manitoba
4610 Winnipeg
4615 Brandon
4625 South Eastman
4630 Interlake
4640 Central
4645 Assiniboine
511
441
765
270
351
295
675
(493–530)
(419–463)
(657–873)
(214–325)
(294–408)
(247–344)
(581–769)
787
885
1,209
339
416
284
779
(740–834)
(814–956)
(961–1,458)
(235–443)
(313–519)
(204–364)
(601–957)
Map
Code
84
Health Region
Scotia
South Shore
South West Nova
Annapolis Valley
Colchester East Hants
Cape Breton
Capital
Age-Standardized
Rate per 10,000
95% CI
Community and Health System Characteristics
Mental Illness Hospitalization
2010 –2011
Mental Illness Patient Days
2010 –2011
Age-Standardized
Rate per 100,000
95% CI
Saskatchewan
4701 Sun Country
4702 Five Hills
4704 Regina
4705 Sunrise
4706 Saskatoon
4709 Prince Albert
4710 Prairie North
601
541
859
535
724
347
818
904
(578–624)
(451–632)
(716–1,002)
(493–577)
(608–839)
(318–375)
(715–920)
(787–1,021)
769
704
1,095
803
1,073
697
704
807
(725–813)
(536–872)
(865–1,325)
(717–889)
(803–1,343)
(613–781)
(579–828)
(633–982)
Alberta
4831 South Zone
4832 Calgary Zone
4833 Central Zone
4834 Edmonton Zone
4835 North Zone
423
737
371
419
339
620
(413–432)
(689–786)
(357–386)
(392–446)
(323–354)
(583–657)
661
988
728
549
608
499
(636–687)
(889–1,087)
(679–776)
(492–607)
(565–651)
(452–546)
594
815
844
765
674
633
534
503
411
590
496
543
616
485
1,019
847
831
(582–606)
(710–919)
(725–963)
(717–812)
(618–729)
(585–682)
(505–564)
(475–530)
(363–460)
(562–619)
(453–539)
(505–580)
(562–670)
(424–547)
(892–1,146)
(768–926)
(722–941)
734
442
651
800
620
720
682
666
377
949
638
942
827
567
852
768
770
(713–755)
(365–518)
(535–767)
(724–876)
(552–689)
(641–799)
(627–737)
(617–716)
(317–437)
(884–1,014)
(557–720)
(840–1,044)
(710–944)
(442–691)
(696–1,008)
(672–865)
(605–935)
Map
Code
Health Region
British Columbia
5911 East Kootenay
5912 Kootenay Boundary
5913 Okanagan
5914 Thompson/Cariboo/Shuswap
5921 Fraser East
5922 Fraser North
5923 Fraser South
5931 Richmond
5932 Vancouver
5933 North Shore
5941 South Vancouver Island
5942 Central Vancouver Island
5943 North Vancouver Island
5951 Northwest
5952 Northern Interior
5953 Northeast
Yukon
Age-Standardized
Rate per 10,000
95% CI
778
(632–925)
591
(396–787)
1,424
(1,235–1,612)
1,062
(580–1,545)
Nunavut
736
(606–866)
452
(337–567)
Canada
467
(464–471)
678
(669–687)
Northwest Territories
Mental illness hospitalization
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 hospitalization rate in general hospitals is a partial measure of hospital utilization in acute settings.
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.
Sources: Discharge Abstract Database and Ontario Mental Health Reporting System, Canadian Institute for Health Information; Fichier des hospitalisations
MED-ÉCHO, ministère de la Santé et des Services sociaux du Québec.
Mental illness patient days
Age-adjusted rate of total number of days in general hospitals for selected mental illness, per 10,000 population age 15 and older. The patient
days rate in general hospitals is a partial measure of hospital utilization in acute settings. 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 health services.
Sources: Discharge Abstract Database and Ontario Mental Health Reporting System, Canadian Institute for Health Information; Fichier des hospitalisations
MED-ÉCHO, ministère de la Santé et des Services sociaux du Québec.
85
Health Indicators 2012
Hip Replacement
2010 –2011
Map
Code
Health Region
Newfoundland and Labrador
1011 Eastern
1012 Central
1013 Western
Age-Standardized
Rate per 100,000
Knee Replacement
2010 –2011
95% CI
Age-Standardized
Rate per 100,000
95% CI
70
74
77
57
78
(63–77)
(63–84)
(60–95)
(42–73)
(63–93)
136
129
141
146
140
(126–146)
(116–142)
(119–163)
(120–172)
(121–160)
109
153
85
106
112
128
103
(103–116)
(123–183)
(63–108)
(85–128)
(88–135)
(109–148)
(93–114)
180
244
118
172
163
208
189
(172–189)
(209–279)
(93–143)
(145–198)
(135–191)
(184–231)
(175–204)
New Brunswick
1301 Zone 1 (Moncton area)
1302 Zone 2 (Saint John area)
1303 Zone 3 (Fredericton area)
1306 Zone 6 (Bathurst area)
100
119
90
105
77
(93–108)
(104–134)
(75–104)
(89–120)
(58–96)
150
141
187
184
97
(141–158)
(125–157)
(167–208)
(163–205)
(76–117)
Quebec
2401 Bas-Saint-Laurent
2402 Saguenay–Lac-Saint-Jean
2403 Capitale-Nationale
2404 Mauricie et Centre-du-Québec
2405 Estrie
2406 Montréal
2407 Outaouais
2408 Abitibi-Témiscamingue
2409 Côte-Nord
2411 Gaspésie–Îles-de-la-Madeleine
2412 Chaudière-Appalaches
2413 Laval
2414 Lanaudière
2415 Laurentides
2416 Montérégie
71
89
68
64
64
77
63
100
61
67
48
80
70
78
83
75
(69–73)
(77–101)
(58–78)
(58–70)
(57–71)
(68–87)
(60–67)
(89–111)
(48–75)
(50–84)
(35–61)
(71–88)
(61–78)
(70–87)
(75–90)
(71–80)
116
170
149
103
130
117
85
179
104
198
112
134
92
116
122
122
(113–118)
(153–187)
(135–162)
(96–110)
(121–140)
(105–129)
(81–89)
(164–194)
(87–121)
(169–227)
(93–132)
(123–145)
(82–102)
(106–126)
(112–132)
(116–128)
Ontario
3501 Erie St. Clair
3502 South West
3503 Waterloo Wellington
3504 Hamilton Niagara Haldimand Brant
3505 Central West
3506 Mississauga Halton
3507 Toronto Central
3508 Central
3509 Central East
3510 South East
3511 Champlain
3512 North Simcoe Muskoka
3513 North East
3514 North West
109
119
132
122
123
68
97
94
91
100
126
110
141
125
163
(107–111)
(110–128)
(125–140)
(114–131)
(117–129)
(62–75)
(90–103)
(88–100)
(86–96)
(94–105)
(116–136)
(104–116)
(130–152)
(116–134)
(146–180)
181
210
205
169
214
173
145
112
143
183
256
179
195
250
231
(179–184)
(199–221)
(195–214)
(158–179)
(206–222)
(163–184)
(137–153)
(106–119)
(136–149)
(176–190)
(243–270)
(171–187)
(182–208)
(237–262)
(211–250)
Manitoba
4610 Winnipeg
4615 Brandon
4625 South Eastman
4630 Interlake
4640 Central
4645 Assiniboine
121
117
128
102
106
131
129
(114–128)
(109–126)
(94–162)
(74–131)
(84–128)
(107–155)
(103–156)
181
170
158
212
202
225
148
(173–189)
(159–180)
(121–194)
(171–253)
(172–232)
(194–257)
(121–175)
Prince Edward Island
Nova
1211
1212
1223
1234
1258
1269
86
Scotia
South Shore
South West Nova
Annapolis Valley
Colchester East Hants
Cape Breton
Capital
Community and Health System Characteristics
Hip Replacement
2010 –2011
Map
Code
Health Region
Age-Standardized
Rate per 100,000
Knee Replacement
2010 –2011
95% CI
Age-Standardized
Rate per 100,000
95% CI
Saskatchewan
4701 Sun Country
4702 Five Hills
4704 Regina
4705 Sunrise
4706 Saskatoon
4709 Prince Albert
4710 Prairie North
128
117
129
115
134
133
121
133
(121–136)
(88–146)
(99–159)
(101–130)
(105–162)
(119–147)
(94–147)
(103–163)
210
165
221
190
222
217
211
187
(200–219)
(129–200)
(182–260)
(172–208)
(185–259)
(198–235)
(177–244)
(151–222)
Alberta
4831 South Zone
4832 Calgary Zone
4833 Central Zone
4834 Edmonton Zone
4835 North Zone
117
144
116
133
110
107
(113–121)
(129–160)
(109–123)
(121–145)
(103–117)
(95–119)
174
280
162
225
146
160
(169–179)
(258–301)
(154–170)
(209–240)
(138–153)
(145–174)
British Columbia
5911 East Kootenay
5912 Kootenay Boundary
5913 Okanagan
5914 Thompson/Cariboo/Shuswap
5921 Fraser East
5922 Fraser North
5923 Fraser South
5931 Richmond
5932 Vancouver
5933 North Shore
5941 South Vancouver Island
5942 Central Vancouver Island
5943 North Vancouver Island
5951 Northwest
5952 Northern Interior
5953 Northeast
108
139
145
129
136
96
86
94
63
65
117
129
124
165
132
173
128
(105–111)
(114–164)
(121–169)
(118–140)
(121–151)
(84–108)
(78–94)
(87–102)
(51–75)
(59–72)
(104–129)
(118–141)
(112–137)
(142–187)
(103–160)
(149–197)
(94–161)
156
241
166
195
156
190
120
168
103
93
152
124
165
172
277
332
194
(152–159)
(208–274)
(140–192)
(182–209)
(140–172)
(173–207)
(110–130)
(158–178)
(87–119)
(84–101)
(137–166)
(113–135)
(151–179)
(151–194)
(236–318)
(300–365)
(154–234)
Yukon
120
(74–166)
212
(151–273)
Northwest Territories
139
(85–193)
126
(77–176)
Nunavut
108
(34–182)
490
(328–652)
Canada
100
(99–101)
160
(159–161)
Hip replacement
Age-standardized rate of unilateral or bilateral hip replacement surgery performed on inpatients in acute care hospitals, per 100,000
population age 20 and older. Hip replacement surgery has the potential to improve functional status, reduce pain and contribute to other
gains in health-related quality of life. Wide inter-regional variation in hip replacement rates may be attributable to numerous factors,
including the availability of services, provider practice patterns and patient preferences.
Sources: Discharge Abstract Database, Canadian Institute for Health Information; Fichier des hospitalisations MED-ÉCHO, ministère de la Santé et des
Services sociaux du Québec.
Knee replacement
Age-standardized rate of unilateral or bilateral knee replacement surgery performed on patients in acute care hospitals or same-day surgery
facilities, per 100,000 population age 20 and older. Knee replacement surgery has the potential to improve functional status, reduce pain
and contribute to other gains in health-related quality of life. Wide inter-regional variation in knee replacement rates may be attributable to
numerous factors, including the availability of services, provider practice patterns and patient preferences.
Sources: Discharge Abstract Database and National Ambulatory Care Reporting System, Canadian Institute for Health Information; Fichier des
hospitalisations MED-ÉCHO, ministère de la Santé et des Services sociaux du Québec.
87
Health Indicators 2012
Percutaneous Coronary Intervention
2010 –2011
Map
Code
Coronary Artery Bypass Graft Surgery
2010 –2011
Age-Standardized
Rate per 100,000
95% CI
Age-Standardized
Rate per 100,000
95% CI
Newfoundland and Labrador
1011 Eastern
1012 Central
1013 Western
146
141
180
126
(136–156)
(128–155)
(155–206)
(101–152)
75
73
88
68
(68–83)
(63–83)
(70–105)
(51–85)
Prince Edward Island
177
(155–199)
60
(47–73)
Nova
1211
1212
1223
1234
1258
1269
174
149
179
179
211
172
169
(166–182)
(120–179)
(147–212)
(151–207)
(177–245)
(149–195)
(156–182)
56
60
51
57
52
65
53
(51–60)
(41–78)
(34–68)
(42–72)
(35–68)
(52–78)
(46–61)
(191–211)
(175–214)
(207–252)
(195–241)
(190–253)
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
71
80
78
79
74
(65–77)
(68–92)
(65–91)
(65–92)
(57–92)
Quebec
2401 Bas-Saint-Laurent
2402 Saguenay–Lac-Saint-Jean
2403 Capitale-Nationale
2404 Mauricie et Centre-du-Québec
2405 Estrie
2406 Montréal
2407 Outaouais
2408 Abitibi-Témiscamingue
2409 Côte-Nord
2411 Gaspésie–Îles-de-la-Madeleine
2412 Chaudière-Appalaches
2413 Laval
2414 Lanaudière
2415 Laurentides
2416 Montérégie
201
194
229
218
221
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
60
58
56
59
62
45
58
53
61
73
77
65
57
61
62
67
(59–62)
(48–68)
(47–64)
(53–65)
(55–69)
(38–53)
(55–62)
(45–61)
(48–74)
(55–91)
(61–93)
(57–72)
(49–64)
(54–69)
(56–69)
(63–72)
Ontario
3501 Erie St. Clair
3502 South West
3503 Waterloo Wellington
3504 Hamilton Niagara Haldimand Brant
3505 Central West
3506 Mississauga Halton
3507 Toronto Central
3508 Central
3509 Central East
3510 South East
3511 Champlain
3512 North Simcoe Muskoka
3513 North East
3514 North West
174
169
139
108
200
191
156
153
155
165
207
188
184
246
284
(171–176)
(159–179)
(132–147)
(100–116)
(192–207)
(180–201)
(148–164)
(145–160)
(148–161)
(158–171)
(194–219)
(180–196)
(171–197)
(233–258)
(262–306)
68
81
68
62
83
69
73
46
56
60
103
52
89
68
105
(66–69)
(74–88)
(63–74)
(55–68)
(78–88)
(62–75)
(68–79)
(41–50)
(52–60)
(56–64)
(94–111)
(48–57)
(80–98)
(62–75)
(92–119)
Manitoba
4610 Winnipeg
4615 Brandon
4625 South Eastman
4630 Interlake
4640 Central
4645 Assiniboine
168
169
80
204
192
155
169
(160–175)
(158–179)
(53–108)
(165–243)
(161–223)
(128–181)
(138–200)
72
71
55
93
78
65
63
(67–77)
(64–78)
(34–77)
(65–120)
(59–97)
(49–82)
(45–80)
Health Region
Scotia
South Shore
South West Nova
Annapolis Valley
Colchester East Hants
Cape Breton
Capital
New Brunswick
1301 Zone 1 (Moncton area)
1302 Zone 2 (Saint John area)
1303 Zone 3 (Fredericton area)
1306 Zone 6 (Bathurst area)
88
Community and Health System Characteristics
Percutaneous Coronary Intervention
2010 –2011
Map
Code
Coronary Artery Bypass Graft Surgery
2010 –2011
Age-Standardized
Rate per 100,000
95% CI
Age-Standardized
Rate per 100,000
95% CI
Saskatchewan
4701 Sun Country
4702 Five Hills
4704 Regina
4705 Sunrise
4706 Saskatoon
4709 Prince Albert
4710 Prairie North
205
133
138
187
150
238
235
172
(196–214)
(101–166)
(107–170)
(169–205)
(120–181)
(219–257)
(200–271)
(138–206)
79
77
60
91
80
63
95
57
(73–85)
(54–101)
(40–80)
(79–104)
(58–102)
(53–73)
(73–118)
(38–77)
Alberta
4831 South Zone
4832 Calgary Zone
4833 Central Zone
4834 Edmonton Zone
4835 North Zone
169
144
151
178
171
239
(165–174)
(129–160)
(143–158)
(164–192)
(163–180)
(221–257)
43
49
35
49
44
51
(40–45)
(40–58)
(32–39)
(41–56)
(39–48)
(42–60)
British Columbia
5911 East Kootenay
5912 Kootenay Boundary
5913 Okanagan
5914 Thompson/Cariboo/Shuswap
5921 Fraser East
5922 Fraser North
5923 Fraser South
5931 Richmond
5932 Vancouver
5933 North Shore
5941 South Vancouver Island
5942 Central Vancouver Island
5943 North Vancouver Island
5951 Northwest
5952 Northern Interior
5953 Northeast
164
142
134
151
141
240
184
181
147
126
128
155
194
176
163
184
216
(160–168)
(116–168)
(110–158)
(139–163)
(126–156)
(221–259)
(172–196)
(171–191)
(129–166)
(117–136)
(115–142)
(143–168)
(179–210)
(152–199)
(131–195)
(160–207)
(173–258)
58
45
49
42
44
75
68
66
49
54
60
48
65
62
93
77
64
(56–61)
(30–59)
(34–63)
(36–48)
(36–52)
(64–86)
(61–76)
(60–72)
(38–60)
(48–61)
(51–70)
(41–55)
(56–74)
(49–75)
(69–117)
(62–93)
(40–89)
(13–63)
Health Region
Yukon
176
(120–232)
38
Northwest Territories
220
(155–285)
63
(27–98)
Nunavut
112
(46–179)
72
(15–129)
Canada
173
(171–174)
63
(62–64)
Percutaneous coronary intervention
Age-standardized rate of percutaneous coronary intervention (PCI) performed on patients in acute care hospitals, same-day surgery
facilities or catheterization laboratories, per 100,000 population age 20 and older. In many cases, PCI serves as a nonsurgical alternative
to coronary artery bypass graft (CABG) surgery and is undertaken for the purpose of opening obstructed coronary arteries. The choice
of revascularization mode (that is, PCI or CABG) depends on numerous factors, including severity of coronary artery disease, physician
preferences, availability of services, referral patterns and differences in population health and socio-economic status.
Note: Rates for Quebec are not available due to differences in data collection; the Canada rate does not include Quebec.
Sources: Discharge Abstract Database and National Ambulatory Care Reporting System, Canadian Institute for Health Information.
Coronary artery bypass graft surgery
Age-standardized rate of coronary artery bypass graft (CABG) surgery performed on inpatients in acute care hospitals, per
100,000 population age 20 and older. As with other types of surgical procedures, variations in CABG surgery rates can be attributed
to numerous factors, including differences in population demographics and health status, physician practice patterns and availability
of services. In cases amenable to treatment with less invasive procedures, percutaneous coronary intervention (PCI), an alternative
treatment to improve blood flow to the heart muscle, may be used. Variations in the extent to which PCI is utilized may result in
variations in bypass surgery.
Sources: Discharge Abstract Database, Canadian Institute for Health Information; Fichier des hospitalisations MED-ÉCHO, ministère de la Santé et des
Services sociaux du Québec.
89
Health Indicators 2012
Cardiac Revascularization
2010 –2011
Map
Code Health Region
Newfoundland and Labrador
1011 Eastern
1012 Central
1013 Western
Age-Standardized
Rate per 100,000
221
214
267
194
95% CI
Hysterectomy
2010 –2011
Age-Standardized
Rate per 100,000
(208–233)
(197–231)
(237–298)
(164–225)
410
375
456
504
95% CI
(381–438)
(341–410)
(384–528)
(420–588)
Prince Edward Island
236
(211–261)
407
(350–463)
Nova
1211
1212
1223
1234
1258
1269
229
206
231
235
262
238
221
(219–239)
(171–240)
(194–267)
(203–266)
(224–299)
(211–264)
(206–236)
415
354
521
628
533
497
286
(394–437)
(269–438)
(420–622)
(528–728)
(445–622)
(426–567)
(261–312)
(259–283)
(251–297)
(280–333)
(268–321)
(259–332)
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
.. ..
399
430
372
329
404
(376–423)
(384–476)
(327–417)
(285–373)
(331–478)
Quebec
2401 Bas-Saint-Laurent
2402 Saguenay–Lac-Saint-Jean
2403 Capitale-Nationale
2404 Mauricie et Centre-du-Québec
2405 Estrie
2406 Montréal
2407 Outaouais
2408 Abitibi-Témiscamingue
2409 Côte-Nord
2411 Gaspésie–Îles-de-la-Madeleine
2412 Chaudière-Appalaches
2413 Laval
2414 Lanaudière
2415 Laurentides
2416 Montérégie
271
274
306
295
296
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
300
421
458
250
387
451
201
260
494
328
424
413
249
338
325
310
(294–306)
(371–471)
(414–503)
(232–269)
(357–417)
(410–492)
(191–211)
(233–286)
(433–556)
(272–385)
(353–495)
(380–447)
(226–273)
(311–364)
(301–349)
(296–325)
Ontario
3501 Erie St. Clair
3502 South West
3503 Waterloo Wellington
3504 Hamilton Niagara Haldimand Brant
3505 Central West
3506 Mississauga Halton
3507 Toronto Central
3508 Central
3509 Central East
3510 South East
3511 Champlain
3512 North Simcoe Muskoka
3513 North East
3514 North West
240
250
206
169
282
257
227
198
210
224
304
238
269
312
389
(237–243)
(237–262)
(197–215)
(159–179)
(273–291)
(245–270)
(218–237)
(189–206)
(202–217)
(216–231)
(289–319)
(229–247)
(254–284)
(298–326)
(363–415)
308
431
386
396
361
258
218
173
233
322
374
331
385
497
272
(304–313)
(404–458)
(365–407)
(373–420)
(345–377)
(241–275)
(205–232)
(161–184)
(222–244)
(308–336)
(345–404)
(315–347)
(355–414)
(465–529)
(237–307)
Manitoba
4610 Winnipeg
4615 Brandon
4625 South Eastman
4630 Interlake
4640 Central
4645 Assiniboine
238
239
136
294
270
218
232
(229–248)
(227–251)
(101–170)
(247–342)
(233–306)
(187–249)
(196–268)
380
340
460
406
458
443
548
(362–399)
(318–362)
(362–559)
(324–488)
(377–540)
(376–511)
(451–645)
Scotia
South Shore
South West Nova
Annapolis Valley
Colchester East Hants
Cape Breton
Capital
New Brunswick
1301 Zone 1 (Moncton area)
1302 Zone 2 (Saint John area)
1303 Zone 3 (Fredericton area)
1306 Zone 6 (Bathurst area)
90
Community and Health System Characteristics
Cardiac Revascularization
2010 –2011
Map
Code Health Region
Age-Standardized
Rate per 100,000
95% CI
Hysterectomy
2010 –2011
Age-Standardized
Rate per 100,000
95% CI
Saskatchewan
4701 Sun Country
4702 Five Hills
4704 Regina
4705 Sunrise
4706 Saskatoon
4709 Prince Albert
4710 Prairie North
281
211
194
276
230
297
325
228
(270–292)
(171–250)
(157–232)
(254–298)
(192–268)
(276–319)
(283–367)
(188–267)
435
544
694
386
608
381
296
615
(414–457)
(435–654)
(570–818)
(346–425)
(493–722)
(345–417)
(231–360)
(511–719)
Alberta
4831 South Zone
4832 Calgary Zone
4833 Central Zone
4834 Edmonton Zone
4835 North Zone
211
192
185
226
215
289
(206–217)
(174–210)
(177–194)
(211–241)
(205–224)
(269–309)
371
508
303
515
341
479
(361–382)
(461–554)
(288–318)
(480–551)
(324–359)
(443–515)
British Columbia
5911 East Kootenay
5912 Kootenay Boundary
5913 Okanagan
5914 Thompson/Cariboo/Shuswap
5921 Fraser East
5922 Fraser North
5923 Fraser South
5931 Richmond
5932 Vancouver
5933 North Shore
5941 South Vancouver Island
5942 Central Vancouver Island
5943 North Vancouver Island
5951 Northwest
5952 Northern Interior
5953 Northeast
221
185
183
193
185
311
250
246
194
178
188
201
258
235
256
260
277
(216–225)
(156–215)
(155–211)
(179–206)
(168–202)
(289–333)
(236–264)
(234–258)
(173–216)
(167–190)
(172–204)
(187–216)
(240–276)
(209–262)
(216–296)
(232–288)
(228–326)
299
328
393
387
470
507
216
272
167
152
198
302
498
440
410
658
334
(291–307)
(263–393)
(317–468)
(351–422)
(419–521)
(463–550)
(198–234)
(252–291)
(140–194)
(137–166)
(173–223)
(273–330)
(450–547)
(374–506)
(332–488)
(586–730)
(260–407)
Yukon
214
(153–275)
356
(252–460)
Northwest Territories
283
(209–357)
334
(239–428)
Nunavut
177
(91–263)
258
(132–383)
Canada
235
(233–237)
325
(322–328)
Cardiac revascularization
Age-standardized rate of coronary artery bypass graft (CABG) surgery performed on inpatients in acute care hospitals or percutaneous
coronary intervention (PCI) performed on patients in acute care hospitals, same-day surgery facilities or catheterization laboratories, per
100,000 population age 20 and older. The choice of revascularization mode (that is, PCI or CABG) depends on numerous factors, including
severity of coronary artery disease, physician preferences, availability of services, referral patterns and differences in population health and
socio-economic status. The combined cardiac revascularization rate represents total activity of cardiac revascularization in a jurisdiction.
Note: Rates for Quebec are not available due to differences in data collection; the Canada rate does not include Quebec.
Sources: Discharge Abstract Database and National Ambulatory Care Reporting System, Canadian Institute for Health Information.
Hysterectomy
Age-standardized rate of hysterectomy provided to patients in acute care hospitals or same-day surgery facilities, per 100,000 women age
20 and older. Similar to other types of surgical procedures, variations in hysterectomy rates can be attributed to numerous factors, including
differences in population demographics and health status, physician practice patterns and availability of services.
Sources: Discharge Abstract Database and National Ambulatory Care Reporting System, Canadian Institute for Health Information; Fichier des
hospitalisations MED-ÉCHO, ministère de la Santé et des Services sociaux du Québec.
91
Health Indicators 2012
Inflow/Outflow Ratio, 2010 –2011
Map
Code Health Region
Newfoundland and Labrador
1011 Eastern
1012 Central
1013 Western
Prince Edward Island
Nova
1211
1212
1223
1234
1258
1269
Scotia
South Shore
South West Nova
Annapolis Valley
Colchester East Hants
Cape Breton
Capital
New Brunswick
1301 Zone 1 (Moncton area)
1302 Zone 2 (Saint John area)
1303 Zone 3 (Fredericton area)
1306 Zone 6 (Bathurst area)
Quebec
2401 Bas-Saint-Laurent
2402 Saguenay–Lac-Saint-Jean
2403 Capitale-Nationale
2404 Mauricie et Centre-du-Québec
2405 Estrie
2406 Montréal
2407 Outaouais
2408 Abitibi-Témiscamingue
2409 Côte-Nord
2411 Gaspésie–Îles-de-la-Madeleine
2412 Chaudière-Appalaches
2413 Laval
2414 Lanaudière
2415 Laurentides
2416 Montérégie
Ontario
3501 Erie St. Clair
3502 South West
3503 Waterloo Wellington
3504 Hamilton Niagara Haldimand Brant
3505 Central West
3506 Mississauga Halton
3507 Toronto Central
3508 Central
3509 Central East
3510 South East
3511 Champlain
3512 North Simcoe Muskoka
3513 North East
3514 North West
Manitoba
4610 Winnipeg
4615 Brandon
4625 South Eastman
4630 Interlake
4640 Central
4645 Assiniboine
92
Hysterectomy
..
Percutaneous
Coronary
Intervention
..
0.99
1.07
0.98
1.06
0.91
1.01
1.79
0.00
0.00
1.85
0.00
0.00
0.94
..
0.97
..
0.92
..
0.00
..
0.00
..
0.67
0.75
0.96
0.60
0.91
1.43
..
0.00
0.00
1.72
0.00
1.01
1.55
..
0.00
0.00
1.94
0.00
1.06
1.34
..
0.81
0.79
1.30
0.98
0.74
1.23
..
0.00
0.00
0.00
0.00
0.00
2.91
..
0.00
0.00
0.00
0.00
0.00
3.17
..
1.11
1.15
0.92
0.92
..
1.19
1.03
1.08
1.10
..
1.23
0.98
1.08
0.94
..
1.27
0.94
0.97
0.82
..
0.00
4.20
0.00
0.00
..
0.92
1.00
1.32
0.90
1.09
1.40
0.78
0.97
0.78
0.73
0.78
0.76
0.72
0.76
0.78
..
0.95
1.00
1.15
0.95
0.65
1.83
0.73
0.92
0.80
0.56
1.13
0.37
0.66
0.58
0.69
..
0.98
1.05
1.09
1.04
0.57
1.79
0.82
1.07
0.81
0.67
1.15
0.61
0.60
0.70
0.69
..
0.96
1.03
1.38
0.96
1.05
1.66
0.51
1.00
0.75
0.69
0.73
0.82
0.64
0.63
0.77
..
0.00
3.97
0.00
0.00
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
0.88
1.07
0.90
1.00
0.76
0.96
1.88
0.89
0.82
0.95
1.11
0.87
0.93
0.91
..
0.87
0.99
0.96
0.96
0.73
0.83
2.49
0.86
0.75
1.00
1.03
0.66
0.70
0.95
..
0.89
0.97
0.99
0.94
0.75
0.93
2.65
0.97
0.86
1.02
1.02
0.71
0.75
1.00
..
1.40
1.62
0.60
0.54
0.79
0.55
1.61
0.97
0.00
0.00
1.21
0.00
1.64
2.16
0.00
0.00
0.84
0.00
Overall
..
Hip
Replacement
..
1.10
0.84
0.94
1.02
0.91
1.00
0.91
..
Knee
Replacement
..
Bypass
Surgery
..
..
0.00
1.02
2.62
0.00
1.78
2.99
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
..
0.88
1.11
0.91
1.03
0.58
0.78
2.53
0.91
0.80
1.03
1.13
0.91
0.90
0.71
..
0.58
1.04
1.49
0.99
0.00
1.57
3.03
0.83
0.47
0.93
1.12
0.00
0.92
0.78
..
0.00
1.47
1.41
1.12
0.00
1.38
4.41
1.03
0.00
0.96
1.48
0.00
0.84
0.00
..
1.57
2.02
0.27
0.19
0.28
0.11
1.84
0.00
0.00
0.00
0.00
0.00
1.91
0.00
0.00
0.00
0.00
0.00
Community and Health System Characteristics
Inflow/Outflow Ratio, 2010 –2011
Hip
Replacement
..
Knee
Replacement
..
Hysterectomy
..
Percutaneous
Coronary
Intervention
..
0.55
0.83
1.22
0.83
1.37
0.99
1.06
..
0.00
0.43
1.27
0.00
2.06
0.58
0.00
..
0.00
0.36
1.29
0.00
2.09
0.71
0.00
..
0.31
0.87
1.26
1.11
1.52
0.84
1.46
..
0.00
0.00
1.78
0.00
1.91
0.00
0.00
..
0.00
0.00
1.88
0.00
2.11
0.00
0.00
..
British Columbia
5911 East Kootenay
5912 Kootenay Boundary
5913 Okanagan
5914 Thompson/Cariboo/Shuswap
5921 Fraser East
5922 Fraser North
5923 Fraser South
5931 Richmond
5932 Vancouver
5933 North Shore
5941 South Vancouver Island
5942 Central Vancouver Island
5943 North Vancouver Island
5951 Northwest
5952 Northern Interior
5953 Northeast
0.93
1.07
0.80
1.24
0.79
..
1.03
1.14
0.61
1.23
0.69
..
1.24
1.04
0.65
1.26
0.71
..
0.97
1.06
0.77
1.26
0.60
..
0.00
1.44
0.00
1.87
0.00
..
0.00
1.60
0.00
1.83
0.00
..
0.84
0.84
1.03
0.92
0.91
1.03
0.78
0.96
1.62
0.88
1.15
0.84
0.86
0.84
0.90
0.84
0.74
0.73
1.02
0.51
0.81
0.70
0.51
1.43
3.77
0.72
0.96
0.81
1.01
0.31
0.65
0.78
0.81
0.77
1.04
0.58
0.83
0.82
0.65
2.26
2.74
0.94
0.92
0.84
1.26
0.51
0.86
0.91
0.68
0.84
1.01
0.97
0.89
0.83
0.64
0.96
2.55
0.73
1.07
0.87
1.01
0.95
0.76
0.83
0.00
0.00
1.58
0.00
0.00
2.24
0.00
0.00
3.65
0.00
2.44
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
2.05
0.00
0.00
4.33
0.00
3.24
0.00
0.00
0.00
0.00
0.00
Yukon
0.83
0.00
0.51
0.88
0.00
0.00
Northwest Territories
0.96
0.80
1.13
0.91
0.00
0.00
Nunavut
0.44
..
0.00
..
0.00
..
0.18
..
0.00
..
0.00
..
Map
Code Health Region
Saskatchewan
4701 Sun Country
4702 Five Hills
4704 Regina
4705 Sunrise
4706 Saskatoon
4709 Prince Albert
4710 Prairie North
Alberta
4831 South Zone
4832 Calgary Zone
4833 Central Zone
4834 Edmonton Zone
4835 North Zone
Canada
Overall
..
Bypass
Surgery
..
Inflow/outflow ratio
A ratio of the number of discharges from relevant facilities (acute care/same-day surgery) within a given region divided by the number of
discharges generated by residents of that region. An overall ratio is calculated for discharges associated with any diagnosis or procedure
for acute care discharges only and separately for hip replacement, knee replacement, hysterectomy, percutaneous coronary intervention
(PCI) and coronary artery bypass surgery procedures from all relevant facilities. A ratio of less than one indicates that health care utilization
by residents of a region exceeded care provided within that region, suggesting an outflow effect. A ratio greater than one indicates that care
provided by a region exceeded the utilization by its residents, suggesting an inflow effect. A ratio of one indicates that care provided by a
region is equivalent to the utilization by its residents, suggesting that inflow and outflow activity, if it exists at all, is balanced. A ratio of zero
is an indication that none of the institutions in the region provided the service and residents received care outside of their region.
Note: The PCI inflow/outflow ratios for Quebec are not available due to differences in data collection.
Sources: Discharge Abstract Database and National Ambulatory Care Reporting System, Canadian Institute for Health Information; Fichier des
hospitalisations MED-ÉCHO, ministère de la Santé et des Services sociaux du Québec.
93
Health Indicators 2012
General/Family Physicians
2010
Map
Code Health Region
Newfoundland and Labrador
1011 Eastern
1012 Central
1013 Western
Prince Edward Island
Rate per 100,000
118
120
116
121
Specialist Physicians
2010
95% CI
Rate per 100,000
95% CI
(109–128)
(107–132)
(94–138)
(97–146)
108
137
66
75
(99–117)
(124–150)
(50–83)
(56–94)
89
(74–105)
77
(62–91)
114
117
90
104
89
103
131
(107–121)
(89–145)
(66–115)
(82–126)
(68–111)
(85–121)
(120–141)
111
55
43
75
46
78
172
(105–118)
(36–74)
(26–59)
(56–94)
(31–62)
(62–94)
(159–184)
New Brunswick
1301 Zone 1 (Moncton area)
1302 Zone 2 (Saint John area)
1303 Zone 3 (Fredericton area)
1306 Zone 6 (Bathurst area)
109
108
105
105
111
(101–116)
(94–123)
(89–120)
(89–120)
(87–134)
97
119
113
72
82
(90–104)
(104–134)
(97–129)
(59–84)
(62–102)
Quebec
2401 Bas-Saint-Laurent
2402 Saguenay–Lac-Saint-Jean
2403 Capitale-Nationale
2404 Mauricie et Centre-du-Québec
2405 Estrie
2406 Montréal
2407 Outaouais
2408 Abitibi-Témiscamingue
2409 Côte-Nord
2411 Gaspésie–Îles-de-la-Madeleine
2412 Chaudière-Appalaches
2413 Laval
2414 Lanaudière
2415 Laurentides
2416 Montérégie
111
139
118
153
100
132
120
97
130
143
190
107
89
81
88
93
(109–114)
(122–155)
(105–131)
(143–162)
(91–108)
(119–145)
(115–125)
(86–107)
(112–149)
(119–167)
(162–218)
(97–117)
(80–99)
(73–89)
(80–96)
(88–98)
114
99
81
179
76
142
209
55
84
61
88
74
69
54
48
62
(111–116)
(86–113)
(70–92)
(169–189)
(68–84)
(128–155)
(203–216)
(47–62)
(69–99)
(45–76)
(69–107)
(65–82)
(61–77)
(47–60)
(43–54)
(58–67)
Ontario
3501 Erie St. Clair
3502 South West
3503 Waterloo Wellington
3504 Hamilton Niagara Haldimand Brant
3505 Central West
3506 Mississauga Halton
3507 Toronto Central
3508 Central
3509 Central East
3510 South East
3511 Champlain
3512 North Simcoe Muskoka
3513 North East
3514 North West
92
69
91
83
83
65
76
160
83
71
111
118
88
94
107
(90–94)
(62–75)
(85–98)
(76–89)
(78–88)
(60–71)
(71–81)
(153–167)
(79–87)
(67–76)
(102–120)
(112–124)
(80–97)
(86–102)
(94–121)
97
57
110
60
100
44
61
296
70
58
109
130
54
65
62
(96–99)
(51–62)
(103–116)
(55–66)
(95–105)
(39–48)
(57–66)
(286–305)
(66–74)
(54–61)
(99–118)
(124–137)
(47–60)
(58–72)
(52–72)
Manitoba
4610 Winnipeg
4615 Brandon
4625 South Eastman
4630 Interlake
4640 Central
4645 Assiniboine
99
104
143
66
83
90
99
(93–104)
(96–111)
(110–176)
(47–85)
(64–103)
(72–107)
(76–122)
89
143
84
*
17
17
*
(83–94)
(134–152)
(59–109)
**
(8–26)
(10–25)
**
Nova
1211
1212
1223
1234
1258
1269
94
Scotia
South Shore
South West Nova
Annapolis Valley
Colchester East Hants
Cape Breton
Capital
Community and Health System Characteristics
General/Family Physicians
2010
Map
Code Health Region
Saskatchewan
4701 Sun Country
4702 Five Hills
4704 Regina
4705 Sunrise
4706 Saskatoon
4709 Prince Albert
4710 Prairie North
Alberta
4831 South Zone
4832 Calgary Zone
4833 Central Zone
4834 Edmonton Zone
4835 North Zone
British Columbia
5911 East Kootenay
5912 Kootenay Boundary
5913 Okanagan
5914 Thompson/Cariboo/Shuswap
5921 Fraser East
5922 Fraser North
5923 Fraser South
5931 Richmond
5932 Vancouver
5933 North Shore
5941 South Vancouver Island
5942 Central Vancouver Island
5943 North Vancouver Island
5951 Northwest
5952 Northern Interior
5953 Northeast
Yukon
Northwest Territories
Rate per 100,000
95% CI
Specialist Physicians
2010
Rate per 100,000
95% CI
95
69
75
99
72
117
104
84
109
94
117
90
120
84
119
149
156
121
109
92
83
79
88
169
130
157
129
152
152
125
95
180
(89–101)
(47–91)
(52–99)
(87–112)
(49–95)
(105–129)
(81–126)
(63–106)
(106–113)
(82–105)
(111–122)
(82–99)
(114–127)
(75–93)
(116–122)
(122–176)
(128–183)
(109–132)
(96–123)
(81–103)
(76–91)
(73–86)
(75–101)
(159–178)
(116–143)
(145–170)
(116–143)
(130–174)
(124–180)
(107–143)
(72–118)
(135–224)
75
*
40
86
24
143
47
18
103
59
123
33
145
22
96
43
50
88
58
45
75
48
65
264
69
127
62
66
26
55
13
29
(69–80)
**
(23–56)
(75–97)
(11–37)
(130–156)
(32–63)
(8–28)
(99–106)
(50–68)
(117–129)
(28–38)
(138–152)
(17–26)
(93–98)
(29–58)
(35–66)
(78–97)
(48–68)
(37–53)
(68–81)
(43–53)
(53–76)
(251–276)
(59–78)
(116–139)
(53–71)
(52–81)
(15–38)
(43–67)
(5–21)
(11–47)
55
(33–77)
23
(9–37)
Nunavut
30
(11–49)
*
**
Canada
104
(103–105)
101
(100–102)
Physicians
General/family physicians (family medicine and emergency family medicine specialists) and specialist physicians (medical, surgical
and laboratory specialists) on December 31 of the reference year, per 100,000 population. The data includes active physicians in clinical
practice and those not working in a clinical practice. Active physicians are defined as physicians who have an MD degree, are registered
with a provincial/territorial medical college and have a valid mailing address. The data excludes residents and non-licensed physicians who
requested that their information not be published in the Canadian Medical Directory as of December 31 of the reference year. Generally,
specialist physicians include certificants of the Royal College of Physicians and Surgeons of Canada (RCPSC) and/or the Collège des
médecins du Québec (CMQ), with the exception of Saskatchewan, Newfoundland and Labrador, Nova Scotia, New Brunswick, Yukon and
Alberta, where specialists also include physicians who are licensed as specialists but who are not certified by the RCPSC or the CMQ (that
is, non-certified specialists). For all other jurisdictions, non-certified specialists are counted as general practitioners. With the exception
of the criteria just noted, all other physicians are counted as family practitioners, including certificants of the College of Family Physicians
of Canada. For further methodological information, please see Supply, Distribution and Migration of Canadian Physicians (www.cihi.ca).
Physician-to-population rates are useful indicators and are published by a variety of agencies to support health human resources planning.
However, due to differences in CIHI’s data collection, processing and reporting methodology, CIHI’s results may differ from provincial and
territorial data. Readers are cautioned to avoid inferences regarding the adequacy of provider resources based on supply ratios alone.
Source: Scott’s Medical Database, Canadian Institute for Health Information.
95
Health Indicators 2012
Selected Health Professionals †
2010
Nurses
Dental
Occupational PhysioChiroRNs LPNs Pharmacists Dentists Hygienists Dietitians Therapists therapists practors Optometrists Psychologists
N.L.
P.E.I.
N.S.
N.B.
Que.
Ont.
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T.
Nun.
Canada
1,181
1,026
972
1,076
835
717
935
907
766
679
1,041
122
118
122
96
96
80
107
118
103
89
70
39
90
35
51
56
42
53
64
51
37
55
66
117
122
198
30
59
69
54
66
90
54
48
70
70
79
53
15
31
47
50
45
34
24
32
29
27
24
32
31
41
42
48
33
43
26
40
37
1,443
490
411
374
372
255
229
220
259
195
181
184
197
..
24
27
783
237
92
58
75
28
38
40
41
57
61
48
42
58
55
56
62
93
..
..
11
6
12
8
15
31
21
18
25
23
20
..
..
10
13
11
15
16
14
10
13
14
12
17
0
0
41
25
52
48
94
25
20
45
66
23
..
165
60
49
23
14
47
† Rates per 100,000 population.
Health Expenditure
Current Dollars ($ ’000,000)
Actual
2009
N.L.
P.E.I.
N.S.
N.B.
Que.
Ont.
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T.
Nun.
Canada
Total Health Expenditure
Public
By Use of Funds
GDP (%) Sector (%)
(Percentage Distribution of $ ’000,000), 2009
Capital and
Institutional Professional
Public
Other
2009
2009
Services
Services
Drugs
Health
Health
Forecast
2010
Forecast
2011
3,000
779
5,332
4,302
38,191
71,811
7,314
5,818
21,519
22,972
278
432
365
3,298
842
5,691
4,550
40,010
75,469
7,655
6,309
23,891
24,031
301
439
367
3,500
873
5,930
4,784
41,926
77,438
8,059
6,788
24,936
25,097
314
452
401
12.0
16.4
15.6
15.6
12.6
12.4
14.3
10.3
8.7
12.0
13.7
10.5
24.2
77.1
73.4
69.0
69.9
71.9
68.5
74.8
76.9
72.9
71.0
79.9
84.4
93.2
53.3
41.6
45.7
45.2
41.1
35.9
42.7
40.5
39.5
38.5
37.7
47.7
46.7
17.4
20.1
21.0
21.5
21.6
26.2
20.9
22.4
26.1
24.0
17.0
17.1
17.2
15.0
15.6
17.3
17.1
19.6
16.9
13.5
14.2
13.3
13.0
9.2
6.9
5.8
3.5
4.7
2.4
3.5
4.3
7.1
7.2
9.6
7.0
6.8
19.4
8.1
9.5
10.8
18.0
13.6
12.7
13.4
13.9
15.7
13.3
14.1
17.7
16.7
20.2
20.8
182,113
192,854
200,499
11.9
70.9
39.0
24.2
16.2
6.3
14.3
Public Sector Health Expenditure by Use of Funds
($ per Capita), 2009
Capital and
Institutional Professional
Public
Other
Services
Services
Drugs
Health
Health
Private Sector Health Expenditure by Use of Funds
($ per Capita), 2009
Capital and
Institutional Professional
Public
Other
Services
Services
Drugs
Health
Health
N.L.
P.E.I.
N.S.
N.B.
Que.
Ont.
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T.
Nun.
2,881
2,018
2,262
2,305
1,759
1,597
2,231
2,022
2,071
1,790
2,398
3,855
5,090
701
710
724
731
627
871
794
822
898
618
984
1,403
1,761
280
255
350
271
421
355
311
362
298
225
394
364
348
209
260
137
203
208
388
429
540
412
351
1,602
801
1,081
483
813
445
500
491
555
721
599
597
673
1,221
1,919
2,277
267
277
332
288
246
374
327
267
244
194
718
864
199
325
399
472
502
429
571
461
445
634
619
425
288
189
606
607
633
708
533
575
496
442
479
445
361
318
304
0
0
0
0
0
0
0
0
0
0
0
0
0
153
183
321
233
164
211
226
155
230
236
159
77
79
Canada
1,810
771
342
338
567
297
534
535
0
207
96
Community and Health System Characteristics
Health professionals
Registered nurses (RNs), licensed practical nurses (LPNs), pharmacists (with the exception of Quebec and
Nunavut), physiotherapists and occupational therapists (with the exception of Quebec): rates reflect health
professionals registered with active-practising status and who are employed in these health professions. For
other health professionals, data reflects personnel regardless of employment status and includes the number of
active registered dentists, registered dental hygienists, registered dietitians, registered chiropractors, active
registered optometrists and active registered psychologists.
Notes: Personnel-per-population rates are revised annually using the most recent Statistics Canada population estimates and
therefore may differ slightly from previously published figures. Rates may differ from data published by provincial/territorial
regulatory authorities due to CIHI’s collection, processing and reporting methodology. Please consult Canada’s Health Care
Providers, 2000 to 2009—A Reference Guide for more detailed methodological notes, data quality issues and professionspecific information, or contact us at [email protected]
Sources: Health Personnel Database, Canadian Institute for Health Information; Statistics Canada, Quarterly Demographic
Estimates 24, 4 (March 2011), catalogue no. 91-002-X.
Total health expenditure
Total health expenditure includes any type of expenditure for which the primary objective is to improve or prevent
the deterioration of health status. Presented in current dollars and as a proportion of gross domestic product
(GDP). This definition allows economic activities to be measured according to primary purpose and secondary
effects. Activities that are undertaken with the direct purpose of improving or maintaining health are included.
Other activities are not included, even though they may impact health. For example, funds aligning with housing
and income support policies that have social welfare goals as their primary purpose are not considered to be
health expenditures, yet they are recognized as powerful factors in determining population health.
Source: National Health Expenditure Database, Canadian Institute for Health Information.
Proportion of public sector
Public-sector health expenditure presented as a proportion of total health expenditure.
Public sector includes health care spending by governments and government agencies.
Source: National Health Expenditure Database, Canadian Institute for Health Information.
Total health expenditure by use of funds
Percentage distribution of total health expenditure by health-spending category. Institutional services includes
hospitals and residential care types of facilities that are approved, funded or operated by provincial/territorial
governments. Professional services includes expenditures on primary professional fees paid to physicians
in private practice as well as for the services of privately practising dentists, denturists, chiropractors and
other health professionals. This category does not include the remuneration of health professionals on the
payrolls of hospitals or public-sector health agencies. Physician expenditures generally represents amounts
that flow through provincial medical care plans. Drugs includes expenditures on prescribed drugs and nonprescribed products purchased in retail stores. This category does not include drugs dispensed in hospitals
and other institutions. Public health is that provided by governments and governmental agencies and includes
expenditures for items such as food and drug safety, health inspections, health promotion, community mental
health programs, public health nursing, measures to prevent the spread of communicable diseases and other
related activities. Capital and other health includes expenditure on construction, machinery, equipment
and some software for hospitals, clinics, first-aid stations and residential care facilities (capital); the cost of
providing health insurance programs by the government and private health insurance companies, and all
costs for the infrastructure to operate health departments (administration expenditures); and, at the aggregate
level, expenditures on home care, medical transportation (ambulances), hearing aids, other appliances and
prostheses, health research and miscellaneous health care (other health).
Source: National Health Expenditure Database, Canadian Institute for Health Information.
97
General Notes
General Notes
•
The methodology used for the indicators was designed to maximize inter-regional,
interprovincial and interterritorial comparability given the characteristics of
available national data sets. For this reason, there may be differences between
definitions, data sources and extraction procedures used in some local, regional or
provincial/territorial reports when compared with those described here. In addition,
discrepancies may exist due to ongoing updates to the databases. Data presented
here includes the latest updates available at the time of publication.
•
Health regions are defined by provincial governments as areas of responsibility for
regional health boards (that is, legislated) or as regions of interest to health care
authorities. In order to determine what health region a patient belongs to, postal
codes are first mapped to census geography using Statistics Canada’s Postal Code
Conversion File (PCCF, Vintage May 2011) and then to a health region using another
Statistics Canada product, “Health Regions: Boundaries and Correspondence With
Census Geography.” Boundaries are those that were in effect as of December 2007,
with the exception of Alberta zones, which are current as of December 2010.
•
In Nova Scotia, there are new region codes for district health authorities and zones.
Names remain unchanged.
•
Data for regions with a population of at least 50,000 is reported. This threshold
ensures stability in rates and reduces the risk of suppression stemming from privacy
and confidentiality issues.
•
Records with invalid, missing or partial postal codes cannot be mapped to a health
region and therefore are not included in the regional rates. However, they are
included in the provincial rates when possible. Non-Canadian residents are excluded
from Canada rates; they are identified by mini–postal codes relating to one of the
U.S. states or by a postal code value or other relevant data element indicating outof-country residents.
•
For indicators under the Equity dimension, patients were assigned neighbourhoodlevel income quintiles using Statistics Canada’s Postal Code Conversion File Plus
(PCCF+, version 5J). The postal code of a patient’s place of residence at the time of
hospitalization was mapped to the smallest geographical unit available for analysis
in the 2006 Canadian census—the dissemination area (DA)—and the corresponding
neighbourhood income quintile of that DA was assigned to the patient.
•
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. Patients admitted to non–acute
care hospitals (for example, chronic care, psychiatric or rehabilitation facilities) are
not included in the totals.
•
For procedure-derived indicators (for example, hip and knee replacement,
percutaneous coronary intervention and coronary artery bypass), rates are based
on the total number of discharges rather than the total number of interventions.
For example, a bilateral knee replacement provided at the same admission is
counted as one event. Procedure-derived indicators include discharges from
acute care hospitals and same-day surgery facilities, where applicable.
99
Health Indicators 2012
100
•
For the mental health–related indicators (30-day readmission for mental illness
[MI], repeat hospitalizations for MI, MI hospitalization, MI patient days and selfinjury hospitalization), the population of interest includes discharges from general
hospitals. All free-standing psychiatric hospitals identified by the owners of the
databases used were not included. For the Discharge Abstract Database (DAD),
these include all institutions identified as psychiatric hospitals; for hospitalization
data from Quebec (MED-ÉCHO), these include all centres hospitaliers de soins
psychiatriques. A list of psychiatric hospitals in the Ontario Mental Health Reporting
System (OMHRS) was provided by the OMHRS program area at CIHI. Specialized
acute services can be provided in general hospitals or psychiatric hospitals, and
service delivery may differ slightly across jurisdictions. Therefore, interjurisdictional
comparisons should be done with caution.
•
The mental illnesses selected for the mental health–related indicators (except
self-injury hospitalization) are substance-related disorders; schizophrenia, delusional
and non-organic psychotic disorders; mood disorders; anxiety disorders; and
selected disorders of adult personality and behaviour.
•
Weyburn Mental Health Centre in Saskatchewan is now included in all mental
health–related indicators (30-day readmission for MI, repeat hospitalizations for MI,
MI hospitalization, MI patient days and self-injury hospitalization). As a result, rates
for Sun Country Health Region (4701) are not comparable with those reported in
previous years.
•
For 30-day readmission for MI, MI hospitalization, MI patient days and self-injury
hospitalization for North East LHIN, rates for 2009–2010 and 2010–2011 are not
comparable. This is because Brant Community Healthcare System—Brantford
General Hospital did not submit its 2009–2010 data to the Ontario Mental Health
Reporting System as of the reporting deadline for the Health Indicators 2011 report.
•
Asthma, hysterectomy and prostatectomy readmissions and in-hospital hip
fracture indicators are discontinued as of the Health Indicators 2012 report.
These indicators will continue to be reported in the Canadian Hospital Reporting
Project ([email protected]).
•
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.
•
Due to differences in data submission, the same Manitoba resident treated in and
outside of the province could not be identified as the same individual. This may
affect a small number of cases for indicators that require tracking patients beyond
one hospitalization.
•
See the Health Indicators e-publication (www.cihi.ca or www.statcan.gc.ca)
for diagnosis and procedure codes used to extract the indicator data, detailed
definitions and technical notes. Indicator rates for years prior to those appearing
in this publication are also available in the e-publication.
Indicator Index
Indicator Index
30-day acute myocardial infarction in-hospital mortality
74–75
30-day medical readmission
76–77
30-day obstetric readmission
78–79
30-day pediatric readmission
80–81
30-day readmission for mental illness
80–81
30-day stroke in-hospital mortality
74–75
30-day surgical readmission
78–79
Acute myocardial infarction readmission
76–77
Adult body mass index
54
Ambulatory care sensitive conditions
72–73
Asthma
54
Avoidable mortality from preventable causes
66–67
Avoidable mortality from treatable causes
68–69
Bicycle helmet use
62
Caesarean section
72–73
Cancer incidence, by types of cancer
52
Cardiac revascularization
90–91
Chronic obstructive pulmonary disease
54
Coronary artery bypass graft surgery
88–89
Dependency ratio
48–49
Diabetes
54
Exposure to second-hand smoke
62
Fruit and vegetable consumption
62
Health expenditure
96
Health professionals
96
Heavy drinking
62
High blood pressure
54
Hip replacement
86–87
Hospitalized acute myocardial infarction event
58–59
Hospitalized acute myocardial infarction event, by neighbourhood income quintile 60
Hospitalized acute myocardial infarction event, disparity rate ratio
60
Hospitalized acute myocardial infarction event, potential rate reduction
60
Hospitalized hip fracture event
70–71
Hospitalized stroke event
58–59
Hysterectomy
90–91
Infant mortality
52
Inflow/outflow ratio
92–93
Injury hospitalization
56–57
Injury hospitalization, by neighbourhood income quintile
60
Injury hospitalization, disparity rate ratio
60
Injury hospitalization, potential rate reduction
60
Knee replacement
86–87
Life expectancy at birth
52
Mental illness hospitalization
84–85
101
Health Indicators 2012
Mental illness patient days
Patients with repeat hospitalizations for mental illness
Percutaneous coronary intervention
Perinatal mortality
Physical activity during leisure time
Physicians
Population
Potentially avoidable mortality
Premature mortality
Premature mortality, potential years of life lost
Self-injury hospitalization
Smoking
Wait time for hip fracture surgery
Youth body mass index
102
84–85
82–83
88–89
52
62
94–95
48–49
64–65
50–51
50–51
82–83
62
70–71
54
Health Indicators 2012
Potentially Avoidable Mortality Rates
by Health Region, 2006 to 2008
104
Regional Maps
Age-Standardized Rate per 100,000 Population
Above Canadian Average
Below Canadian Average
Same as Canadian Average
Data Unavailable or Suppressed
Notes
For Prince Edward Island (1100), Yukon (6001), the Northwest Territories (6101)
and Nunavut (6201), the data on the map represents the entire province or territory.
Rates for smaller regions (population between 20,000 and 50,000) are available
in the e-publication at www.cihi.ca.
Source
Vital Statistics—Death Database, Statistics Canada.
105
106
B
by Health Region, 2006 to 2008
Avoidable Mortality
From Preventable Causes
A
Health Indicators 2012
B
by Health Region, 2006 to 2008
Avoidable Mortality
From Treatable Causes
Same as Canadian Average
Data Unavailable or Suppressed
Notes
For Prince Edward Island (1100), Yukon (6001), the Northwest Territories (6101) and Nunavut (6201), the data on the
map represents the entire province or territory.
Rates for smaller regions (population between 20,000 and 50,000) are available in the e-publication at www.cihi.ca.
Source
Vital Statistics—Death Database, Statistics Canada.
Above Canadian Average
Below Canadian Average
Age-Standardized Rate per 100,000 Population
A
Regional Maps
107
From cover
to
e-cover
CIHI, in partnership with Statistics Canada, maintains the
country’s most comprehensive set of regional health indicators.
Health Indicators 2012 provides you with a sample of these.
For even more health indicators and data on more health
regions, as well as related information, take a look at our
Health Indicators e-publication, available online!
www.cihi.ca
or
www.statcan.gc.ca
Health
Indicators
Data Tables
and Maps
Definitions
and
Technical
Notes
Access all
available CIHI
and Statistics
Canada health
indicators.
Explore data
tables, selecting
items such as
geography, age
group and sex.
Find definitions,
data sources and
methodologies
for health
indicators.
Highlights
Get a general
overview of
the state of the
health system
and the health
of Canadians.
Production of this report is made possible by financial contributions from Health
Canada and provincial and territorial governments. The views expressed herein
do not necessarily represent the views of Health Canada or any provincial
or territorial government.
All rights reserved.
The contents of this publication may be reproduced unaltered, in whole or in part
and by any means, solely for non-commercial purposes, provided that the Canadian
Institute for Health Information is properly and fully acknowledged as the copyright
owner. Any reproduction or use of this publication or its contents for any commercial
purpose requires the prior written authorization of the Canadian Institute for Health
Information. Reproduction or use that suggests endorsement by, or affiliation with,
the Canadian Institute for Health Information is prohibited.
For permission or information, please contact CIHI:
Canadian Institute for Health Information
495 Richmond Road, Suite 600
Ottawa, Ontario K2A 4H6
Phone: 613-241-7860
Fax: 613-241-8120
www.cihi.ca
[email protected]
ISBN 978-1-77109-046-9 (PDF)
© 2012 Canadian Institute for Health Information
How to cite this document:
Canadian Institute for Health Information, Health Indicators 2012 (Ottawa,
Ont.: CIHI, 2012).
Cette publication est aussi disponible en français sous le titre Indicateurs
de santé 2012.
ISBN 978-1-77109-047-6 (PDF)
Talk to Us
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Phone: 613-241-7860
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