Dynamic Cohort of Complex, High System Users – 2011-2015

A CIHR-CIHI Collaboration

Winter 2017

Table of Contents

Overview of the Dynamic Cohort

CIHR and the Canadian Institute for Health Information (CIHI) have partnered to create a dynamic cohort of complex, high system users. The cohort was developed using CIHI’s in-house datasets (e.g., hospitalizations, ER visits, and costing data) to facilitate cross-jurisdictional research. The research priorities generated for SPOR’s Primary and Integrated Health Care Innovations (PIHCI) Network were considered when building the cohort, which resulted in the development of 8 subset cohorts to encompass various definitions of “complex, high system user”, and two age groups: Children (<18 years old) and Adults (≥ 18 years):

  1. Highest acute care cost (eg. patients with very costly interventions and investigations): Children
  2. Highest acute care cost (eg. patients with very costly interventions and investigations): Adults
  3. Highest length of stay (eg. patients waiting for alternative care): Children
  4. Highest length of stay (eg. patients waiting for alternative care): Adults
  5. Most frequent hospitalizations (eg. patients at risk of frequent exacerbations / deterioration): Children
  6. Most frequent hospitalizations (eg. patients at risk of frequent exacerbations / deterioration): Adults
  7. Most frequent emergency room visits (eg. patients who lack a primary care team or patients who suffer from uncontrolled illness): Children
  8. Most frequent emergency room visits (eg. patients who lack a primary care team or patients who suffer from uncontrolled illness): Adults

For each subset, CIHI stratified hospitalization and ED visit records by age group (Children, Adults), province and year, and then identified the top 10% of patients with respect to 1) acute care cost, 2) length of stay, 3) number of hospitalizations, 4) number of ED visits. To create the control group, a 20% random sample was selected from the remaining 90% of non-high users. The cohort currently includes data from 2011-2012 to 2014-2015 and will be updated each year as data becomes available. Patients that are selected each year will be followed forward in time, updating their records each year. This will allow researchers to investigate sporadic, persistent and one-time high system users.

The dynamic cohort is available from CIHI for all research funding opportunities and we encourage those applying to use it as a way of assisting in the rapid turn-around required for many of the cross-jurisdictional research projects.

For more information on the Dynamic Cohort, please contact CIHI’s Corporate Data Request Program at cdrp@cihi.ca.

Accessing the Dynamic Cohort from CIHI

Dynamic Cohort Data Request Process at CIHI

  1. CIHI and CIHR have developed a streamlined process for the researcher to access the data.
  2. CIHI will work with researcher to determine if there are any inclusion/exclusion criteria and any linkage requirements for the data request. A detailed specifications document and cost estimate are prepared and approved by the requesting researcher. A cost of $150/hour will be incurred for data extraction, linkage and verification. Linkage and verification is estimated to require ½ hour per database
  3. CIHI’s Privacy, Confidentiality and Security Committee reviews and approves requests that include data linkage (within and across data holdings).
  4. CIHI extracts, verifies, and releases data to researcher in a secure manner.

For more information on this process and to access the data please contact CIHI’s Corporate Data Request Program at cdrp@cihi.ca.

Assumptions

  • The cohorts can be linked to other data holdings at CIHI, as required by the specific research programs brought forth by researchers, via CIHI’s custom data request process.
  • Only data that CIHI is authorized to disclose through its Data Sharing Agreements with provinces and territories, and that are required to support the research, will be included.

CIHI Data Holdings

See a detailed list of data holdings.

Hospital Data

  • Discharge Abstract Database (DAD)
    The Discharge Abstract Database (DAD) captures administrative, clinical and demographic information on hospital discharges (including deaths, sign-outs and transfers). Some provinces and territories also use the DAD to capture day surgery.
  • Hospital Mental Health Database (HMHDB)
    The Hospital Mental Health Database (HMHDB) contains data from across Canada on hospitalizations for mental illness. It also provides demographic and medical diagnosis information from all provinces and territories for inpatient hospital stays for mental illness reasons.
  • National Rehabilitation Reporting System (NRS)
    The National Rehabilitation Reporting System (NRS) collects data from participating Adult inpatient rehabilitation facilities and programs across Canada.
  • Canadian Joint Replacement Registry (CJRR)
    The Canadian Joint Replacement Registry (CJRR) was launched in May 2001 as a voluntary registry and has now been mandated by selected provinces. It was developed to provide a rich set of additional patient-level clinical, surgical and prosthesis information beyond what is captured in the Hospital Morbidity Database and the Discharge Abstract Database, allowing for more in-depth analysis of hip and knee replacement procedures.
  • Canadian Organ Replacement Register (CORR)
    The Canadian Organ Replacement Register (CORR) is a national database that provides statistics to track long-term trends for dialysis activity, organ transplantation, organ donation, and wait list statistics.
  • Ontario Mental Health Reporting System (OMHRS)
    The Ontario Mental Health Reporting System (OMHRS) collects, analyzes and reports on information submitted to CIHI about individuals admitted to designated Adult mental health beds in Ontario. It includes information about mental and physical health, social support and service use.

Ambulatory and Community Care

  • National Ambulatory Care Reporting System (NACRS)
    The National Ambulatory Care Reporting System (NACRS) contains data for all hospital-based and community-based ambulatory care: day surgery, outpatient and community-based clinics, and emergency departments.
  • Home Care Reporting System (HCRS)
    The Home Care Reporting System (HCRS) contains demographic, clinical, functional and resource utilization information on clients served by publicly funded home care programs in Canada. HCRS captures data on clients at multiple points throughout their home care services. Information on organization characteristics that supports comparative reporting and benchmarking is also captured.
  • Continuing Care Reporting System (CCRS)
    The Continuing Care Reporting System (CCRS), launched in 2003–2004, contains demographic, clinical, functional and resource utilization information on individuals receiving continuing care services in hospitals or long-term care homes in Canada. Information on facility characteristics that supports comparative reporting and benchmarking is also captured.

Other (where linkable at the patient level)

  • Health Workforce Databases (Health Workforce)
    CIHI's Health Workforce Database includes information about 30 groups of health care professionals—information such as practice setting, regulatory environment, supply, and demographic, education and employment characteristics. This information is used by health care planners, decision-makers, policy-makers and researchers to support resource and use planning.
  • National Prescription Drug Utilization Information System (NPDUIS)
    The National Prescription Drug Utilization Information System Database contains prescription claims-level data collected from publicly financed drug benefit programs in Canada. The database also contains supporting information for additional context: Formulary and drug product information; and information on policies of public drug plans in Canada.
  • In addition, data may be linked to other geographical and population information available at CIHI, including Statistics Canada’s reference population files and postal code conversion file (PCCF).

The Dynamic Cohort Methodology of Descriptive Statistics

1. Highest Acute Care Cost

Cohort description

This cohort is created using CIHI’s Cost of a Standard Hospital Stay (CSHS) indicator for acute inpatient hospitalization data from CIHI’s Discharge Abstract Database (DAD). The CSHS is an indicator that measures the relative cost-efficiency of a hospital's ability to provide acute inpatient care. This indicator compares a hospital's total acute inpatient care expenses to the number of acute inpatient weighted cases related to the inpatients for which care was provided. The result is the hospital's average full cost of treating the average acute inpatient. A high cost for a standard hospital stay indicates a relatively high cost of treating the average acute inpatient; a low cost for a standard hospital stay indicates that the cost of treating the average acute inpatient is relatively low.

CSHS is used in conjunction with a Resource Intensity Weight (RIW) to estimate the cost of an acute inpatient hospital stay for each individual patient. These cost estimates are adjusted between provinces to account for different administrative structures (for example: some provinces are regionalized and other not) and for some data quality issues.

For this cohort, please note that provincial CSHS values will be used to calculate patient cost estimates.

Methodological notes about the CSHS indicator

Cohort selection: High Acute Care Cost Users and Controls

The cohort was created by first stratifying by year, province (by patient residence), and age group Children (age < 18) and for Adults (age ≥18). Starting with the first hospitalization in the year, the costs for each hospitalization were summed using the patient level costs generated by CSHS, and then the top 10% of high cumulative acute care cost patients within each stratum. Within each stratum, a control group is randomly selected from the 90% in the bottom deciles, using a sampling ratio of 4:1.

Time Frame and database for cohort selection

The cohort includes the fiscal years of 2011-2012 to 2014-2015 inclusively. Each year the cohort selection process was (and will be) repeated, adding the patients for that fiscal year updating the data for all the patients previously selected. The dynamic nature of the cohort allows for the patients selected to be followed forward in time. Baseline data corresponding to the 2 years prior to the selection of the patient in the cohort is also available.

Exclusions

  1. Acute inpatient records from provinces for which a provincial CSHS value was not available (Quebec).
  2. Acute inpatient records for which an RIW was not assigned.

Descriptive statistics: Top 10% Highest Acute Care Cost (2014-2015)

    Total Population High User Cohort
Descriptive Stats: Age		 High User Cohort
Descriptive Stats: Cost		 Gender Analysis
Child
/
Adult		 Prov Total # of unique patients in this population # of High Users identified by Cumulative Cost Min Max Med Mean Std Dev Min
($)		 Max
($)		 Median
($)		 Mean
($)		 Std Dev
($)		 Ratio M:F
Adult AB 230,788 23,086 18 105 70 67.78 17.99 33,600.96 2,214,986.32 58,048.56 80,500.79 71,699.08 1.11
Child AB 71,581 7,159 0 17 0 4.61 6.27 10,724.80 1,625,840.84 24,517.08 47,400.98 79,221.80 1.16
Adult BC 257,278 25,729 18 106 73 69.45 17.54 28,503.69 1,800,279.83 45,858.16 61,340.65 48,914.61 1.15
Child BC 56,577 5,658 0 17 0 5.45 6.68 7,863.37 980,146.00 17,229.10 31,122.62 49,969.76 1.14
Adult MB 75,917 7,592 18 104 74 71.03 17.10 32,270.32 4,399,769.69 56,563.70 79,630.34 91,966.79 0.99
Child MB 21,077 2,123 0 17 0 4.42 6.25 7,783.68 963,230.50 15,810.97 32,750.81 54,707.04 1.08
Adult NB 51,089 5,109 18 104 73 71.32 15.48 27,482.89 3,551,452.21 44,902.11 67,009.31 90,988.96 1.00
Child NB 10,651 1,071 0 17 3 6.26 6.74 7,351.92 868,766.07 13,795.96 26,527.72 46,207.03 1.15
Adult NL 33,075 3,308 18 101 71 68.98 15.35 32,228.50 574,218.36 54,861.97 75,161.43 58,809.85 1.07
Child NL 6,453 646 0 17 2 5.94 6.69 8,917.59 445,688.25 18,810.85 36,427.90 52,773.70 1.20
Adult NS 55,463 5,547 18 103 73 70.40 15.95 32,322.41 2,268,618.95 54,169.92 74,487.57 70,116.29 1.02
Child NS 11,638 1,169 0 17 1 5.76 6.70 8,688.68 809,163.23 18,309.31 37,509.27 66,088.22 1.07
Adult ON 678,481 67,851 18 108 72 69.47 16.13 22,588.89 3,161,722.85 36,124.06 51,294.14 51,902.73 1.17
Child ON 184,385 18,439 0 17 0 4.99 6.46 7,174.20 1,722,919.84 15,386.57 29,755.58 49,816.18 1.10
Adult PE 9,794 980 18 101 72 70.74 15.16 32,357.20 799,993.21 53,725.38 70,050.54 53,060.42 0.97
Child PE 2,217 222 0 17 0 5.16 6.50 8,357.50 297,075.65 14,259.75 27,864.07 36,874.79 1.22
Adult SK 76,744 7,675 18 104 71 68.27 18.29 30,889.46 822,745.55 50,021.37 66,346.46 52,302.07 1.05
Child SK 22,457 2,246 0 17 1 4.88 6.27 9,694.58 1,107,775.26 19,963.67 41,450.75 72,033.31 1.17
Adult TE 3,532 354 18 95 63 60.73 16.77 24,273.17 581,114.44 42,694.22 64,991.21 65,014.22 1.41
Child TE 1,267 127 0 17 0 2.80 5.07 18,877.53 731,329.91 35,723.24 66,367.59 104,083.25 1.23

Descriptive statistics: Control Group – Acute Care Cost (2014-2015)

    Population Control Cohort
Descriptive Stats: Age		 Control Cohort
Descriptive Stats: Cost		 Gender Analysis
Child/Adult Prov Total # of unique patients in this population # of Selected Controls for High Users identified by Cumulative Cost Min Max Median Mean Std Dev Min
($)		 Max
($)		 Median
($)		 Mean
($)		 Std Dev
($)		 Ratio M:F
Adult AB 230,788 92,344 18 106 47 49.61 20.72 705.83 33,589.19 5,771.45 8,240.09 6,370.16 0.54
Child AB 71,581 28,636 0 17 0 1.72 4.29 705.83 10,724.01 1,720.99 2,522.05 2,039.32 1.05
Adult BC 257,278 102,916 18 109 58 55.93 21.41 525.43 28,495.51 5,170.75 7,288.80 5,759.85 0.65
Child BC 56,577 22,632 0 17 0 1.78 4.35 525.43 7,833.56 1,281.14 1,893.87 1,482.39 1.08
Adult MB 75,917 30,368 18 108 52 52.26 21.89 553.03 32,266.63 4,987.76 7,368.74 6,330.38 0.55
Child MB 21,077 8,492 0 17 0 1.75 4.43 553.03 7,748.00 1,348.44 1,845.31 1,480.05 1.02
Adult NB 51,089 20,436 18 105 60 57.16 20.83 464.53 27,471.53 4,890.26 6,893.97 5,513.66 0.69
Child NB 10,651 4,284 0 17 0 2.17 4.57 464.53 7,330.22 1,172.44 1,793.47 1,367.92 1.03
Adult NL 33,075 13,232 18 102 59 55.87 20.19 549.00 32,224.75 5,466.35 7,890.92 6,337.99 0.66
Child NL 6,453 2,584 0 17 0 3.05 5.30 737.88 8,901.96 1,614.33 2,289.91 1,690.35 1.02
Adult NS 55,463 22,188 18 106 59 56.31 20.73 549.00 32,287.61 5,704.93 8,043.34 6,439.59 0.67
Child NS 11,638 4,676 0 17 0 2.02 4.60 549.00 8,653.87 1,338.60 2,091.51 1,698.67 1.01
Adult ON 678,481 271,404 18 108 57 55.86 21.49 486.10 22,587.27 4,506.86 6,215.47 4,574.89 0.57
Child ON 184,385 73,756 0 17 0 1.72 4.20 486.10 7,173.12 1,185.25 1,753.64 1,384.28 1.05
Adult PE 9,794 3,920 18 104 58 55.84 21.15 537.90 32,310.20 5,331.14 8,032.74 6,719.66 0.65
Child PE 2,217 888 0 17 0 2.50 4.90 737.88 8,338.95 1,564.64 2,369.65 1,816.23 1.01
Adult SK 76,744 30,700 18 106 53 52.75 22.26 642.40 30,870.17 5,570.79 7,951.93 6,227.75 0.56
Child SK 22,457 8,984 0 17 0 2.21 4.72 642.40 9,687.43 1,615.01 2,418.86 1,893.65 1.00
Adult TE 3,532 1,416 18 98 46 46.52 18.42 691.19 24,204.01 5,281.16 6,788.11 4,752.44 0.62
Child TE 1,267 508 0 17 0 3.21 5.59 691.19 18,479.46 1,963.61 3,555.35 3,603.87 1.04

Descriptive statistics: Top 10% Highest Acute Care Cost (2013-2014)

    Total Population High User Cohort
Descriptive Stats: Age		 High User Cohort
Descriptive Stats: Cost		 Gender Analysis
Child
/
Adult		 Prov Total # of unique patients in this population # of High Users identified by Cumulative Cost Min Max Med Mean Std Dev Min
($)		 Max
($)		 Median
($)		 Mean
($)		 Std Dev
($)		 Ratio M:F
Adult AB 22,5724 22,573 18 108 70 67.33 17.92 31,966.87 2,117,171.48 54,052.54 75,397.69 69,738.18 1.12
Child AB 69,382 6,965 0 17 0 4.55 6.26 10,286.73 1,538,612.23 22,890.66 43,804.53 69,294.94 1.18
Adult BC 258,770 25,877 18 106 72 69.13 17.45 27,779.34 1,203,836.38 44,218.49 59,731.56 50,261.40 1.14
Child BC 57,092 5,800 0 17 0 5.51 6.70 7,758.50 627,556.52 16,615.81 30,078.46 43,709.54 1.14
Adult MB 74,499 7,450 18 106 74 70.50 17.26 31,276.17 10,907,499.42 54,249.21 77,371.93 143,847.60 1.04
Child MB 20,914 2,093 0 17 0 4.91 6.46 7,424.14 915,461.99 15,378.62 31,977.88 58,288.94 1.12
Adult NB 51,348 5,135 18 112 73 70.49 16.26 27,205.79 2,925,992.90 44,690.40 64,694.55 76,624.46 1.00
Child NB 10,638 1,064 0 17 2 6.20 6.78 6,943.43 360,075.98 12,417.92 23,413.47 29,783.49 1.17
Adult NL 33,240 3,324 18 100 70 68.17 15.65 27,356.57 943,764.91 46,159.82 64,319.87 54,749.98 1.13
Child NL 6,363 638 0 17 3 5.80 6.48 8,028.62 655,274.36 17,857.96 33,988.47 54,849.76 1.08
Adult NS 54,290 5,429 18 104 73 70.43 16.27 29,538.41 2,097,320.33 49,309.06 71,246.68 75,123.65 1.00
Child NS 11,940 1,218 0 17 3 6.11 6.68 7,781.99 1,514,430.36 15,538.17 31,779.94 66,747.00 1.02
Adult ON 669,937 66,996 17 109 72 69.37 16.03 22,215.03 2,949,361.18 35,243.31 50,415.92 51,270.29 1.18
Child ON 183,568 18,514 0 17 0 4.80 6.45 6,993.61 2,902,561.53 14,504.99 28,415.79 54,071.98 1.10
Adult PE 9,854 986 18 100 73 70.71 15.70 30,402.98 1,199,444.63 50,734.02 69,853.20 69,311.64 0.98
Child PE 2,283 229 0 17 0 5.14 6.74 9,233.91 114,367.45 16,534.94 23,862.03 19,717.65 1.16
Adult SK 75,893 7,590 18 108 72 68.52 17.75 29,863.02 1,181,509.59 47,722.16 64,094.14 52,770.68 1.08
Child SK 22,278 2,228 0 17 0 4.90 6.36 9,231.05 979,145.29 18,684.08 36,552.16 61,763.54 1.21
Adult TE 3,369 337 18 100 62 60.53 16.77 25,010.36 838,192.59 41,895.92 66,947.72 78,302.85 1.36
Child TE 1,245 125 0 17 0 3.70 5.78 14,135.49 552,398.93 28,853.91 53,285.31 76,141.02 1.12

Descriptive statistics: Control Group – Acute Care Cost (2013-2014)

    Population Control Cohort
Descriptive Stats: Age		 Control Cohort
Descriptive Stats: Cost		 Gender Analysis
Child/Adult Prov Total # of unique patients in this population # of Selected Controls for High Users identified by Cumulative Cost Min Max Median Mean Std Dev Min
($)		 Max
($)		 Median
($)		 Mean
($)		 Std Dev ($) Ratio M:F
Adult AB 225,724 90,292 18 108 47 49.54 20.69 561.41 31,966.87 5,791.83 8,232.23 6,139.24 0.54
Child AB 69,382 27,860 0 17 0 1.72 4.29 744.35 10,267.03 1,750.21 2,455.90 1,951.62 1.04
Adult BC 258,770 103,508 18 107 57 55.68 21.24 518.83 27,773.62 5,118.98 7,245.87 5,607.61 0.65
Child BC 57,092 23,200 0 17 0 1.92 4.51 598.00 7,756.22 1,320.05 1,923.17 1,475.70 1.05
Adult MB 74,499 29,800 18 106 52 52.14 21.83 589.80 31,267.16 5,097.38 7,392.93 6,098.71 0.54
Child MB 20,914 8,372 0 17 0 1.80 4.51 589.80 7,409.73 1,386.81 1,831.84 1,436.25 1.00
Adult NB 51,348 20,540 18 105 59 56.74 20.69 535.75 27,195.42 5,125.60 7,193.22 5,486.18 0.66
Child NB 10,638 4,256 0 17 0 2.30 4.72 570.66 6,915.15 1,432.66 1,993.64 1,399.33 1.02
Adult NL 33,240 13,296 18 101 58 55.43 19.89 518.83 27,321.15 5,122.51 7,202.30 5,489.80 0.68
Child NL 6,363 2,552 0 17 0 3.25 5.49 652.48 8,022.83 1,500.35 2,125.61 1,538.62 0.99
Adult NS 54,290 21,716 18 104 59 56.12 20.75 563.11 29,536.69 5,562.82 7,684.47 5,915.55 0.65
Child NS 11,940 4,872 0 17 0 2.11 4.66 654.85 7,757.33 1,324.04 2,038.56 1,609.12 1.00
Adult ON 669,937 267,984 18 110 57 55.52 21.38 518.83 22,214.50 4,568.01 6,261.09 4,502.78 0.57
Child ON 183,568 74,056 0 17 0 1.76 4.29 518.83 6,992.55 1,219.93 1,758.76 1,358.93 1.04
Adult PE 9,854 3,944 18 100 57 55.18 20.98 883.57 30,350.32 5,221.85 7,732.02 6,164.49 0.63
Child PE 2,283 916 0 17 0 2.88 5.34 781.80 9,144.10 1,612.06 2,289.62 1,677.90 1.00
Adult SK 75,893 30,360 18 105 53 52.70 22.09 672.82 29,850.68 5,627.15 7,960.99 6,017.65 0.57
Child SK 22,278 8,912 0 17 0 2.31 4.83 672.82 9,223.51 1,582.01 2,394.39 1,829.76 1.00
Adult TE 3,369 1,348 18 96 44 45.60 18.56 518.83 24,891.69 5,845.94 7,141.17 4,681.32 0.60
Child TE 1,245 500 0 17 0 2.98 5.40 757.11 14,000.86 2,249.30 3,229.29 2,766.37 1.02

Descriptive statistics: Top 10% Highest Acute Care Cost (2012-2013)

    Total Population High User Cohort
Descriptive Stats: Age		 High User Cohort
Descriptive Stats: Cost		 Gender Analysis
Child
/
Adult		 Prov Total # of unique patients in this population # of High Users identified by Cumulative Cost Min Max Med Mean Std Dev Min
($)		 Max
($)		 Median
($)		 Mean
($)		 Std Dev
($)		 Ratio M:F
Adult AB 219,289 21,929 18 105 71 67.66 17.92 31,781.56 2,485,658.55 53,410.90 74,616.21 70,772.20 1.08
Child AB 69,099 6,910 0 17 0 4.52 6.24 9,886.20 1,209,561.35 22,199.80 41,977.39 68,146.48 1.18
Adult BC 251,064 25,108 18 104 73 69.63 17.30 26,692.14 2,230,413.53 42,853.26 57,810.22 49,536.78 1.14
Child BC 58,119 5,812 0 17 0 5.41 6.65 7,322.10 927,579.74 15,139.68 27,874.33 42,849.69 1.16
Adult MB 75,048 7,506 18 105 74 70.54 17.35 29,972.39 2,231,604.58 53,360.37 76,853.29 79,180.98 1.00
Child MB 21,272 2,128 0 17 0 4.73 6.43 7,560.37 1,265,722.55 15,230.55 30,568.62 56,931.24 1.16
Adult NB 52,011 5,202 18 101 73 70.36 16.23 26,170.03 1,976,493.57 43,714.07 64,420.77 73,470.14 0.94
Child NB 11,192 1,120 0 17 1 5.83 6.63 7,107.64 413,467.20 13,587.58 23,607.58 29,339.02 1.02
Adult NL 33,658 3,366 18 105 71 68.95 15.30 29,575.27 799,343.08 47,865.74 67,638.46 60,273.98 1.14
Child NL 5,587 559 0 17 6 7.33 6.70 8,548.25 812,446.70 15,209.98 30,962.02 48,982.02 1.12
Adult NS 54,541 5,456 18 105 73 70.43 16.01 28,682.52 949,300.64 49,300.34 69,457.19 57,828.60 1.05
Child NS 12,334 1,245 0 17 2 6.14 6.77 7,712.33 677,147.29 16,496.18 31,007.43 48,389.05 1.12
Adult ON 666,646 66,665 17 107 72 69.33 16.06 21,930.73 2,313,186.39 34,819.25 49,698.67 50,262.63 1.16
Child ON 185,911 18,657 0 17 0 4.71 6.39 7,033.72 907,850.26 14,599.22 27,716.25 42,435.85 1.14
Adult PE 9,891 990 18 100 74 71.20 15.38 31,253.38 670,489.50 51,251.24 66,675.13 46,410.02 1.10
Child PE 2,234 224 0 17 0 5.28 6.61 9,612.59 407,393.97 18,777.46 36,163.51 55,069.05 1.04
Adult SK 74,563 7,457 17 106 72 68.55 18.06 29,364.12 1,525,406.31 46,702.08 63,771.01 61,602.37 1.08
Child SK 22,365 2,237 0 17 0 4.85 6.36 8,901.86 918,874.07 17,811.68 36,338.81 57,501.74 1.18
Adult TE 3,576 358 19 94 61 59.32 16.44 23,511.62 559,047.30 38,788.44 55,167.77 49,094.01 1.34
Child TE 1,157 116 0 17 0 3.26 5.70 15,283.08 560,587.80 30,328.05 55,499.94 69,568.57 1.15

Descriptive statistics: Control Group – Acute Care Cost (2012-2013)

    Population   Control Cohort
Descriptive Stats: Age		 Control Cohort
Descriptive Stats: Cost		 Gender Analysis
Child/Adult Prov Total # of unique patients in this population # of Selected Controls for High Users identified by Cumulative Cost Min Max Median Mean Std Dev Min
($)		 Max
($)		 Median
($)		 Mean
($)		 Std Dev
($)		 Ratio M:F
Adult AB 219,289 87,716 18 107 48 49.82 20.89 651.53 31,774.91 5,648.66 8,166.36 6,182.83 0.54
Child AB 69,099 27,640 0 17 0 1.88 4.49 615.90 9,880.29 1,706.20 2,454.10 1,944.33 1.05
Adult BC 251,064 100,432 18 106 57 55.60 21.38 537.97 26,685.57 4,989.13 6,988.28 5,392.95 0.64
Child BC 58,119 23,248 0 17 0 1.86 4.43 537.97 7,311.40 1,264.95 1,852.36 1,434.13 1.06
Adult MB 75,048 30,024 18 106 52 52.08 21.86 578.22 29,961.21 4,992.55 7,147.04 5,862.83 0.56
Child MB 21,272 8,512 0 17 0 2.04 4.74 578.22 7,549.69 1,359.57 1,867.73 1,460.92 1.00
Adult NB 52,011 20,808 18 108 59 56.47 20.91 539.06 26,164.54 5,017.01 7,061.22 5,337.50 0.67
Child NB 11,192 4,480 0 17 0 2.53 4.90 574.19 7,107.64 1,441.51 2,021.93 1,441.54 1.08
Adult NL 33,658 13,464 18 102 58 55.38 20.00 555.85 29,568.35 5,446.04 7,859.29 5,951.54 0.67
Child NL 5,587 2,236 0 17 0 3.74 5.63 719.34 8,491.56 2,025.73 2,512.77 1,712.26 1.04
Adult NS 54,541 21,824 18 106 58 55.89 20.91 522.20 28,663.27 5,365.52 7,480.65 5,674.71 0.65
Child NS 12,334 4,980 0 17 0 2.28 4.79 555.85 7,700.45 1,306.99 2,059.87 1,632.72 1.02
Adult ON 666,646 266,660 18 114 56 55.32 21.43 522.20 21,930.20 4,572.16 6,232.39 4,460.63 0.58
Child ON 185,911 74,628 0 17 0 1.79 4.34 522.20 7,031.07 1,227.86 1,765.79 1,363.42 1.05
Adult PE 9,891 3,960 18 104 57 55.78 21.07 555.85 31,186.57 5,268.09 7,866.34 6,374.68 0.71
Child PE 2,234 896 0 17 0 3.03 5.30 612.98 9,559.85 1,959.09 2,614.55 1,937.31 1.06
Adult SK 74,563 29,828 18 104 53 53.11 22.40 651.53 29,364.12 5,449.13 7,715.45 5,858.33 0.56
Child SK 22,365 8,948 0 17 0 2.45 4.96 573.03 8,883.28 1,737.64 2,396.17 1,803.31 1.03
Adult TE 3,576 1,432 18 92 44 45.61 18.33 651.53 23,407.96 5,481.88 6,921.13 4,657.63 0.66
Child TE 1,157 464 0 17 0 3.54 5.70 615.90 14,589.09 2,501.72 3,532.21 3,000.42 1.08

Descriptive statistics: Top 10% Highest Acute Care Cost (2011-2012)

    Total Population High User Cohort
Descriptive Stats: Age		 High User Cohort
Descriptive Stats: Cost		 Gender Analysis
Child
/
Adult		 Prov Total # of unique patients in this population # of High Users identified by Cumulative Cost Min Max Med Mean Std Dev Min
($)		 Max
($)		 Median
($)		 Mean
($)		 Std Dev
($)		 Ratio M:F
Adult AB 214,902 21,491 18 107 71 67.63 17.89 29,296.90 2,855,175.85 50,340.32 70,655.98 74,009.99 1.08
Child AB 66,772 6,680 0 17 0 4.56 6.22 9,163.80 1,654,724.20 20,207.76 39,675.94 65,241.11 1.28
Adult BC 249,121 24,915 18 107 73 69.11 17.51 24,786.28 7,988,578.89 39,820.33 54,701.43 68,954.97 1.13
Child BC 58,268 5,827 0 17 0 5.27 6.52 6,998.25 1,558,544.26 14,739.84 26,703.56 44,575.72 1.16
Adult MB 75,775 7,578 18 105 74 70.58 17.21 2,8612.28 1,438,112.13 49,629.26 69,096.20 68,326.06 0.99
Child MB 20,872 2,088 0 17 0 5.16 6.61 68,53.09 1,395,843.89 13,721.95 28,604.39 61,175.37 1.23
Adult NB 53,010 5,301 18 105 73 70.11 16.28 25,671.99 1,092,657.61 41,738.93 60,109.95 56,775.89 0.97
Child NB 11,656 1,166 0 17 3 6.30 6.72 7,035.00 281,797.87 12,802.31 22,551.22 28,830.06 1.09
Adult NL 33,896 3,390 18 104 70 68.20 15.43 29,978.87 1,271,818.46 49,143.66 68,828.99 66,880.17 1.12
Child NL 5,391 540 0 17 6 7.17 6.87 9,469.07 711,959.56 19,475.48 36,377.88 55,239.58 1.26
Adult NS 54,910 5,491 18 104 73 70.51 15.96 28,425.90 3,229,930.98 48,204.72 65,950.72 70,852.04 1.01
Child NS 12,739 1,284 0 17 2 5.78 6.66 7,503.17 940,611.33 14,130.57 29,400.75 48,671.17 1.16
Adult ON 658,447 65,987 17 107 72 69.33 16.03 21,529.60 9,033,957.14 34,272.92 49,381.77 61,661.56 1.16
Child ON 188,531 18,854 0 17 0 4.66 6.33 6,822.02 969,955.10 14,319.06 26,884.03 41,146.05 1.20
Adult PE 9,941 995 18 102 74 70.97 15.53 29,651.47 3,414,424.40 47,935.24 65,704.99 115,713.45 1.06
Child PE 2,426 243 0 17 0 5.78 7.01 8,137.40 266,200.88 17,387.45 29,345.62 37,171.44 1.17
Adult SK 74,110 7,411 18 107 73 68.76 18.02 28,347.92 908,796.76 45,653.31 62,062.96 52,476.05 1.03
Child SK 22,163 2,219 0 17 1 5.09 6.47 8,485.08 542,319.35 16,707.37 31,423.65 43,308.90 1.18
Adult TE 3,479 348 18 100 61 58.99 18.86 22,846.87 453,613.74 37,829.55 55,059.09 51,313.74 1.10
Child TE 1,107 111 0 17 0 3.90 6.19 17,193.85 997,928.21 36,585.68 74,131.11 121,642.59 1.06

Descriptive statistics: Control Group – Acute Care Cost (2011-2012)

    Population Control Cohort
Descriptive Stats: Age		 Control Cohort
Descriptive Stats: Cost		 Gender Analysis
Child/
Adult		 Prov Total # of unique patients in this population # of Selected Controls for High Users identified by Cumulative Cost Min Max Median Mean Std Dev Min
($)		 Max
($)		 Median
($)		 Mean
($)		 Std Dev ($) Ratio
M:F
Adult AB 214,902 85,964 18 105 48 50.05 20.91 519.08 29,294.83 5,334.65 7,635.88 5,779.53 0.55
Child AB 66,772 26,720 0 17 0 1.91 4.51 675.69 9,160.35 1,588.77 2,282.35 1,811.02 1.05
Adult BC 249,121 99,660 18 106 56 55.41 21.37 510.46 24,783.68 4,743.82 6,627.66 5,086.47 0.63
Child BC 58,268 23,308 0 17 0 1.91 4.48 543.73 6,994.09 1,200.25 1,763.60 1,358.45 1.06
Adult MB 75,775 30,312 18 104 53 52.70 21.91 519.08 28,600.46 4,776.60 6,973.16 5,745.85 0.57
Child MB 20,872 8,352 0 17 0 2.19 4.91 553.20 6,846.89 1,300.76 1,748.90 1,331.27 1.03
Adult NB 53,010 21,204 18 110 59 56.49 20.83 519.08 25,667.53 5,058.97 7,086.86 5,277.60 0.65
Child NB 11,656 4,664 0 17 0 2.70 5.01 547.46 6,974.24 1,463.98 2,079.93 1,441.92 1.08
Adult NL 33,896 13,560 18 104 57 55.55 19.95 649.84 29,968.29 5,921.39 8,313.90 6,113.96 0.69
Child NL 5,391 2,160 0 17 0 4.35 5.87 755.73 9,462.45 2,422.69 2,843.88 1,888.87 1.06
Adult NS 54,910 21,964 18 104 58 55.73 20.85 542.93 28,414.85 5,194.33 7,391.95 5,737.48 0.64
Child NS 12,739 5,136 0 17 0 2.38 4.93 578.32 7,488.79 1,451.87 2,031.28 1,550.80 1.03
Adult ON 658,447 263,948 18 112 56 55.15 21.38 519.08 21,529.07 4,499.91 6,180.10 4,420.49 0.57
Child ON 188,531 75,416 0 17 0 1.81 4.32 519.08 6,821.49 1,220.52 1,783.35 1,363.17 1.06
Adult PE 9,941 3,980 18 102 57 55.16 20.93 542.93 29,615.96 4,876.47 7,430.88 6,053.15 0.64
Child PE 2,426 972 0 17 0 2.92 5.27 792.28 8,018.45 1,812.95 2,338.20 1,698.42 1.05
Adult SK 74,110 29,644 18 104 53 53.27 22.40 553.20 2,8342.15 5,245.65 7,552.00 5,822.67 0.57
Child SK 22,163 8,876 0 17 0 2.65 5.10 670.45 8,484.44 1,683.17 2,362.88 1,742.44 0.99
Adult TE 3,479 1,392 18 98 44 45.87 18.41 1052.62 22,568.15 5,336.44 6,742.21 4,429.18 0.61
Child TE 1,107 444 0 17 0 3.36 5.64 744.89 16,937.18 2,328.49 3,508.65 3,271.47 1.11

2. Highest Length of Stay

Cohort description

This cohort is created using CIHI’s Discharge Abstract Database (DAD) and the Ontario Mental Health Reporting System (OMHRS). The OMHRS contains records for patients admitted to the designated Adult inpatient mental health beds in the province of Ontario.

CIHI uses the inpatient DAD database and the OMHRS to sum the different lengths of hospital stay for each patient within each fiscal year.

Acute inpatient hospitalization data submitted from Quebec will not be included. However, patients with QC postal codes who were hospitalized outside of QC will be included.

Cohort selection: Highest Length of Stay Users and Controls

The cohort was created by first stratifying by year, province (by patient residence), and age group Children (age < 18) and for Adults (age ≥18). Starting with the first hospitalization in the year, the length of stay for each hospitalization was summed, and then the top 10% of cumulative length of stay patients within each stratum was identified. Within each stratum, a control group is randomly selected from the 90% in the bottom deciles, using a sampling ratio of 4:1.

Time Frame and database for cohort selection

This cohort includes the fiscal years of 2011-2012 to 2014-2015 inclusively. Each year the cohort selection process was/will be repeated, adding the patients for that fiscal year and updating the data for all the patients previously selected. The dynamic nature of the cohort allows for the patients selected to be followed forward in time. Baseline data corresponding to the 2 years prior to the selection of the patient in the cohort is also available.

Exclusions

  1. Hospitalization records with gender = undefined or other
  2. Hospitalization records with an invalid/missing health card number or birthdate
  3. Hospitalization records with an invalid/missing admission date
  4. Hospitalization records with an invalid/missing discharge date
  5. Hospitalization records belonging to non-Canadian residents

Descriptive statistics: Top 10% Highest Length of Hospital Stay (2014-2015)

    Total Population High User Cohort
Descriptive Stats: Age		 High User Cohort
Descriptive Stats: Cumulative LOS		 Gender Analysis
Child
/
Adult		 Province Total # of unique patients in this population # of High Users identified by Cumulative Length of Stay Min Max Median Mean Std Dev Min Max Median Mean Std Dev Ratio M:F
Adult AB 230,849 23,875 18 105 73 68.83 18.92 25 1175 46 63.37 55.84 0.95
Child AB 71,598 7,190 0 17 0 4.44 6.35 7 663 14 25.25 33.62 1.08
Adult BC 257,339 26,516 18 110 75 70.61 18.65 29 927 49 63.05 42.27 0.98
Child BC 56,582 6,398 0 17 0 4.66 6.48 6 459 12 21.70 28.08 1.13
Adult MB 75,940 7,616 18 104 76 72.07 17.87 34 2858 61 87.70 91.63 0.86
Child MB 21,079 2,123 0 17 0 4.44 6.39 7 351 13 22.59 27.07 1.01
Adult NB 51,115 5,233 18 104 75 72.33 16.51 33 3977 57 89.70 130.55 0.85
Child NB 10,654 1,128 0 17 0 5.70 6.75 7 365 14 22.94 29.60 1.10
Adult NL 33,101 3,328 18 101 72 70.28 15.80 31 1713 51 73.40 67.05 0.92
Child NL 6,456 720 0 17 2 5.85 6.68 7 306 13 22.37 27.22 1.21
Adult NS 55,474 5,665 18 103 75 71.77 16.71 31 1407 54 76.59 71.20 0.88
Child NS 11,639 1,207 0 17 0 4.53 6.36 7 626 13 24.57 36.42 1.10
Adult ON 702,908 72,328 18 108 73 69.07 18.61 22 2020 36 49.41 48.53 0.96
Child ON 185,066 20,435 0 17 0 4.86 6.57 6 1188 11 20.57 27.98 1.03
Adult PE 9,796 984 18 101 75 71.31 16.59 35 789 58.5 77.42 57.69 0.85
Child PE 2,217 244 0 17 0 5.10 6.74 8 195 15 24.40 27.52 1.26
Adult SK 76,753 7,817 18 104 74 69.36 19.24 26 1117 43 55.90 43.63 0.91
Child SK 22,457 2,331 0 17 0 4.53 6.31 7 510 12 21.78 30.15 1.05
Adult TERR 7,223 745 18 96 61 58.77 18.81 17 419 29 47.03 50.15 1.24
Child TERR 2,860 325 0 17 0 4.19 6.15 8 320 13 23.85 32.10 1.18

Descriptive statistics: Control Group – Length of Hospital Stay (2014-2015)

    Population Control Cohort
Descriptive Stats: Age		 Control Cohort
Descriptive Stats: Cumulative LOS		 Gender Analysis
Child/Adult Prov Total # of unique patients in this population # of Selected Controls for High Users identified by Cumulative Length of Stay Min Max Median Mean Std Dev Min Max Median Mean Std Dev Ratio M:F
Adult AB 230,849 95,500 18 106 47 49.51 20.43 1 24 3 4.41 4.74 0.55
Child AB 71,598 28,760 0 17 0 1.69 4.25 1 6 2 1.85 1.12 1.07
Adult BC 257,339 106,064 18 109 58 55.77 21.11 1 28 3 5.45 5.81 0.67
Child BC 56,582 25,592 0 17 0 1.82 4.38 1 5 2 1.98 1.07 1.08
Adult MB 75,940 30,464 18 102 52 52.04 21.69 1 33 3 5.87 6.62 0.56
Child MB 21,079 8,492 0 17 0 1.80 4.48 1 6 2 2.05 1.17 1.04
Adult NB 51,115 20,932 18 107 60 56.93 20.65 1 32 4 6.36 6.64 0.69
Child NB 10,654 4,512 0 17 0 2.27 4.66 1 6 2 2.15 1.18 1.04
Adult NL 33,101 13,312 18 105 59 55.76 19.94 1 30 4 6.33 6.32 0.70
Child NL 6,456 2,880 0 17 0 2.86 5.20 1 6 2 2.23 1.19 1.04
Adult NS 55,474 22,660 18 106 59 55.97 20.62 1 30 4 6.09 6.25 0.67
Child NS 11,639 4,828 0 17 0 2.17 4.80 1 6 2 2.29 1.19 1.04
Adult ON 702,908 28,9312 18 110 57 55.32 21.22 1 21 3 4.60 4.46 0.61
Child ON 185,066 81,740 0 17 0 1.76 4.25 1 5 2 1.83 1.00 1.05
Adult PE 9,796 3,936 18 106 58 55.77 20.97 1 34 4 6.90 7.27 0.64
Child PE 2,217 976 0 17 0 2.47 4.83 1 7 2 2.60 1.44 1.15
Adult SK 76,753 31,268 18 106 53 52.52 21.91 1 25 3 5.11 5.16 0.58
Child SK 22,457 9,324 0 17 0 2.30 4.82 1 6 2 2.08 1.20 1.01
Adult TE 7,223 2,980 18 98 40 43.88 18.73 1 16 3 3.71 3.20 0.48
Child TE 2,860 1,300 0 17 0 2.93 5.43 1 7 2 2.40 1.50 0.99

Descriptive statistics: Top 10% Highest Length of Hospital Stay (2013-2014)

    Total Population High User Cohort
Descriptive Stats: Age		 High User Cohort
Descriptive Stats: Cumulative LOS		 Gender Analysis
Child
/
Adult		 Province Total # of unique patients in this population # of High Users identified by Cumulative Length of Stay Min Max Median Mean Std Dev Min Max Median Mean Std Dev Ratio M:F
Adult AB 225,793 23,149 18 108 73 68.53 18.84 25 1237 45 60.52 49.34 0.95
Child AB 69,391 7,778 0 17 0 4.45 6.34 6 589 13 23.00 31.39 1.13
Adult BC 258,813 26,186 18 106 75 70.41 18.57 29 686 49 63.07 42.94 0.94
Child BC 57,094 6,501 0 17 0 4.92 6.57 6 318 12 21.88 26.50 1.11
Adult MB 74,520 7,465 18 106 76 71.64 18.09 33 4374 61 86.33 91.58 0.90
Child MB 20,914 2,423 0 17 0 4.63 6.44 6 480 11 20.92 31.39 1.08
Adult NB 51,379 5,228 18 112 75 71.74 16.78 31 3416 54 81.79 107.29 0.83
Child NB 10,640 1,135 0 17 0 5.67 6.76 7 449 12 21.61 27.56 1.10
Adult NL 33,249 3,354 18 101 72 69.40 16.24 29 758 48 68.46 57.07 0.96
Child NL 6,363 722 0 17 1 5.57 6.60 7 340 14 24.94 31.18 0.94
Adult NS 54,308 5,453 18 104 76 71.83 16.81 31 1353 53 78.42 72.61 0.83
Child NS 11,942 1,443 0 17 0 5.07 6.48 6 1053 10 21.40 45.13 1.02
Adult ON 694,235 70,785 18 109 73 68.83 18.56 22 1538 36 49.12 44.88 0.96
Child ON 184,372 20,634 0 17 0 4.92 6.63 6 685 11 20.63 27.62 1.03
Adult PE 9,855 1,013 18 100 75 71.46 17.11 34 1954 60 81.20 80.38 0.84
Child PE 2,283 262 0 17 0 5.05 6.78 8 90 15 21.02 16.30 1.13
Adult SK 75,907 7,614 18 108 74 69.40 18.98 26 1429 43 56.32 44.82 0.93
Child SK 22,280 2,271 0 17 0 4.74 6.40 7 411 12 21.80 28.44 1.11
Adult TERR 7,209 776 18 100 60 58.08 19.37 16 557 28.5 42.93 40.42 1.25
Child TERR 2,940 294 0 17 0 3.56 5.69 8 312 14 23.51 28.44 1.03

Descriptive statistics: Control Group – Length of Hospital Stay (2013-2014)

    Population Control Cohort
Descriptive Stats: Age		 Control Cohort
Descriptive Stats: Cumulative LOS		 Gender Analysis
Child/Adult Prov Total # of unique patients in this population # of Selected Controls for High Users identified by Cumulative Length of Stay Min Max Median Mean Std Dev Min Max Median Mean Std Dev Ratio M:F
Adult AB 225,793 92,596 18 106 47 49.45 20.44 1 24 3 4.47 4.79 0.56
Child AB 69,391 31,112 0 17 0 1.73 4.29 1 5 1 1.78 0.99 1.05
Adult BC 258,813 104,744 18 106 57 55.52 20.94 1 28 3 5.40 5.82 0.67
Child BC 57,094 26,004 0 17 0 1.97 4.57 1 5 2 1.97 1.06 1.05
Adult MB 74,520 29,860 18 108 52 51.92 21.61 1 32 3 5.84 6.49 0.55
Child MB 20,914 9,692 0 17 0 1.86 4.56 1 5 2 1.97 1.04 1.01
Adult NB 51,379 20,912 18 107 59 56.62 20.54 1 30 4 6.10 6.16 0.68
Child NB 10,640 4,540 0 17 0 2.37 4.76 1 6 2 2.23 1.20 1.07
Adult NL 33,249 13,416 18 101 58 55.13 19.69 1 28 4 5.95 5.77 0.68
Child NL 6,363 2,888 0 17 0 3.16 5.37 1 6 2 2.24 1.18 1.08
Adult NS 54,308 21,812 18 105 59 56.09 20.54 1 30 4 6.06 6.18 0.66
Child NS 11,942 5,772 0 17 0 2.16 4.71 1 5 2 2.23 1.05 1.00
Adult ON 694,235 283,140 18 109 56 54.88 21.15 1 21 3 4.64 4.48 0.60
Child ON 184,372 82,536 0 17 0 1.78 4.30 1 5 2 1.87 1.01 1.05
Adult PE 9,855 4,052 18 101 57 55.00 20.74 1 33 4 6.43 6.73 0.65
Child PE 2,283 1,048 0 17 0 2.84 5.20 1 7 2 2.68 1.49 1.03
Adult SK 75,907 30,456 18 105 53 52.75 21.82 1 25 3 5.17 5.23 0.59
Child SK 22,280 9,084 0 17 0 2.29 4.78 1 6 2 2.11 1.19 1.02
Adult TE 7,209 3,104 18 99 38 42.55 18.26 1 15 3 3.55 3.03 0.51
Child TE 2,940 1,176 0 17 0 2.92 5.45 1 7 2 2.35 1.47 1.03

Descriptive statistics: Top 10% Highest Length of Hospital Stay (2012-2013)

    Total Population High User Cohort
Descriptive Stats: Age		 High User Cohort
Descriptive Stats: Cumulative LOS		 Gender Analysis
Child
/
Adult		 Province Total # of unique patients in this population # of High Users identified by Cumulative Length of Stay Min Max Median Mean Std Dev Min Max Median Mean Std Dev Ratio M:F
Adult AB 219,345 22,771 18 105 73 68.85 18.87 25 1211 45 61.41 52.08 0.93
Child AB 69,114 7,762 0 17 0 4.27 6.23 6 795 12 21.74 31.00 1.13
Adult BC 251,114 25,439 18 105 76 70.79 18.41 29 749 49 63.43 42.48 0.93
Child BC 58,122 6,639 0 17 0 4.60 6.41 6 347 12 21.47 26.74 1.15
Adult MB 75,073 7,716 18 105 76 71.61 18.00 31 2503 58 85.58 88.32 0.85
Child MB 21,273 2,494 0 17 0 4.54 6.44 6 707 11 19.84 29.49 1.11
Adult NB 52,031 5,277 18 101 75 71.24 16.97 30 2661 53 79.85 95.57 0.78
Child NB 11,195 1,196 0 17 0 5.27 6.62 7 209 12 20.81 23.45 1.02
Adult NL 33,674 3,425 18 105 73 70.74 15.71 28 619 47 63.22 48.59 0.93
Child NL 5,587 655 0 17 5 7.00 6.74 7 814 12 22.50 41.65 1.16
Adult NS 54,556 5,679 18 106 75 71.70 16.69 29 1735 52 76.22 69.14 0.90
Child NS 12,336 1,500 0 17 0 4.73 6.41 6 385 10 20.68 29.42 1.07
Adult ON 690,928 70,681 18 107 73 69.04 18.33 22 2206 36 48.94 45.04 0.94
Child ON 186,779 20,883 0 17 0 4.72 6.54 6 536 12 20.53 26.37 1.07
Adult PE 9,893 996 18 100 75 71.28 16.58 36 395 60 78.55 51.83 0.97
Child PE 2,234 236 0 17 0 5.50 6.96 10 192 17 27.42 28.00 0.80
Adult SK 74,572 7,616 18 108 75 69.87 19.05 26 2751 42.5 56.18 51.99 0.91
Child SK 22,366 2,294 0 17 0 4.58 6.39 7 418 12 22.28 30.91 1.10
Adult TERR 7,374 738 18 97 61 58.53 18.64 17 458 29 42.24 38.78 1.13
Child TERR 2,848 303 0 17 0 4.26 6.35 8 235 13 24.47 30.18 1.06

Descriptive statistics: Control Group – Length of Hospital Stay (2012-2013)

    Population Control Cohort
Descriptive Stats: Age		 Control Cohort
Descriptive Stats: Cumulative LOS		 Gender Analysis
Child
/
Adult		 Prov Total # of unique patients in this population # of Selected Controls for High Users identified by Cumulative Length of Stay Min Max Median Mean Std Dev Min Max Median Mean Std Dev Ratio M:F
Adult AB 219,345 91,084 18 105 48 49.62 20.58 1 24 3 4.58 4.85 0.55
Child AB 69,114 31,048 0 17 0 1.88 4.47 1 5 2 1.82 1.02 1.07
Adult BC 251,114 101,756 18 109 57 55.42 21.14 1 28 3 5.47 5.85 0.66
Child BC 58,122 26,556 0 17 0 1.95 4.52 1 5 2 2.01 1.08 1.05
Adult MB 75,073 30,864 18 106 52 51.97 21.64 1 30 3 5.59 6.06 0.57
Child MB 21,273 9,976 0 17 0 2.04 4.75 1 5 2 1.97 1.04 1.00
Adult NB 52,031 21,108 18 104 59 56.36 20.73 1 29 4 6.08 6.15 0.69
Child NB 11,195 4,784 0 17 0 2.49 4.81 1 6 2 2.24 1.20 1.03
Adult NL 33,674 13,700 18 103 57 55.09 19.75 1 27 4 6.10 5.78 0.69
Child NL 5,587 2,620 0 17 0 3.81 5.63 1 6 2 2.33 1.29 1.04
Adult NS 54,556 22,716 18 107 58 55.82 20.65 1 28 4 5.93 5.90 0.66
Child NS 12,336 6,000 0 17 0 2.37 4.91 1 5 2 2.22 1.06 1.05
Adult ON 690,928 282,724 18 114 56 54.62 21.20 1 21 3 4.69 4.49 0.60
Child ON 186,779 83,532 0 17 0 1.82 4.36 1 5 2 1.90 1.02 1.06
Adult PE 9,893 3,984 18 103 58 55.59 20.77 1 35 4 6.83 7.18 0.69
Child PE 2,234 944 0 17 0 2.95 5.20 1 9 2 2.91 1.80 1.05
Adult SK 74,572 30,464 18 104 53 52.76 22.15 1 25 3 5.20 5.17 0.58
Child SK 22,366 9,176 0 17 0 2.47 4.93 1 6 2 2.16 1.25 1.02
Adult TE 7,374 2,952 18 99 40 43.67 18.53 1 16 3 3.91 3.38 0.53
Child TE 2,848 1,212 0 17 0 2.92 5.43 1 7 2 2.45 1.50 0.93

Descriptive statistics: Top 10% Highest Length of Hospital Stay (2011-2012)

    Total Population High User Cohort
Descriptive Stats: Age		 High User Cohort
Descriptive Stats: Cumulative LOS		 Gender Analysis
Child
/
Adult		 Province Total # of unique patients in this population # of High Users identified by Cumulative Length of Stay Min Max Median Mean Std Dev Min Max Median Mean Std Dev Ratio M:F
Adult AB 214,959 21,559 18 107 73 68.89 18.68 26 1395 47 63.50 55.50 0.92
Child AB 66,790 7,341 0 17 0 4.30 6.21 6 997 12 22.22 30.31 1.24
Adult BC 249,162 25,639 18 106 75 70.15 18.64 28 6660 48 62.68 60.48 0.93
Child BC 58,274 6,560 0 17 0 4.46 6.31 6 407 12 21.79 26.89 1.16
Adult MB 75,796 7,779 18 105 77 71.84 17.91 31 2270 57 80.35 78.98 0.86
Child MB 20,873 2,342 0 17 0 4.71 6.57 6 1790 11 20.50 46.53 1.12
Adult NB 53,028 5,383 18 105 75 71.13 17.11 29 1809 49 73.60 78.91 0.83
Child NB 11,656 1,194 0 17 0 5.47 6.68 7 192 12 20.52 22.23 1.14
Adult NL 33,916 3,500 18 102 72 69.51 15.96 28 562 45 60.63 46.83 0.97
Child NL 5,392 549 0 17 5 6.92 6.82 8 340 15 27.30 33.77 1.21
Adult NS 54,928 5,597 18 104 75 71.46 16.72 30 3458 52 74.03 74.75 0.82
Child NS 12,742 1,550 0 17 0 5.01 6.55 6 542 10 20.74 32.60 1.14
Adult ON 682,032 70,583 18 109 73 68.94 18.21 22 3948 36 49.18 46.96 0.93
Child ON 189,240 20,770 0 17 0 4.48 6.39 6 663 11 20.11 25.98 1.13
Adult PE 9,942 997 18 102 75 71.43 16.73 34 3896 57 76.79 129.65 0.87
Child PE 2,426 256 0 17 0 5.14 6.99 9 271 15 24.90 30.38 1.15
Adult SK 74,127 7,700 18 107 75 69.80 18.95 26 815 43 56.77 40.97 0.89
Child SK 22,164 2,259 0 17 0 4.68 6.41 7 386 12 20.83 26.22 1.17
Adult TERR 7,302 733 18 100 62 58.56 19.77 17 337 31 43.65 37.34 1.04
Child TERR 2,684 300 0 17 0 4.09 6.37 8 351 14 27.05 39.58 1.27

Descriptive Statistics: Control Group – Length of Hospital Stay (2011-2012)

    Population Control Cohort
Descriptive Stats: Age		 Control Cohort
Descriptive Stats: Cumulative LOS		 Gender Analysis
Child
/
Adult		 Prov Total # of unique patients in this population # of Selected Controls for High Users identified by Cumulative Legnth of Stay Min Max Median Mean Std Dev Min Max Median Mean Std Dev Ratio M:F
Adult AB 214,959 86,236 18 106 48 49.93 20.69 1 25 3 4.74 5.10 0.56
Child AB 66,790 29,364 0 17 0 1.89 4.47 1 5 1 1.82 1.03 1.05
Adult BC 249,162 102,556 18 106 56 55.25 21.17 1 27 3 5.47 5.74 0.66
Child BC 58,274 26,240 0 17 0 1.97 4.54 1 5 2 2.04 1.10 1.07
Adult MB 75,796 31,116 18 107 52 52.38 21.88 1 30 3 5.83 6.25 0.57
Child MB 20,873 9,368 0 17 0 2.16 4.85 1 5 2 2.01 1.03 1.03
Adult NB 53,028 21,532 18 110 58 56.30 20.77 1 28 4 6.14 6.07 0.66
Child NB 11,656 4,776 0 17 0 2.81 5.10 1 6 2 2.27 1.22 1.03
Adult NL 33,916 14,000 18 105 57 55.38 19.78 1 27 4 6.26 5.90 0.69
Child NL 5,392 2,196 0 17 1 4.45 5.89 1 7 2 2.46 1.45 1.12
Adult NS 54,928 22,388 18 106 58 55.45 20.69 1 29 4 6.11 6.12 0.65
Child NS 12,742 6,200 0 17 0 2.35 4.87 1 5 2 2.29 1.09 1.01
Adult ON 682,032 282,332 18 112 55 54.52 21.20 1 21 3 4.83 4.57 0.60
Child ON 189,240 83,080 0 17 0 1.88 4.39 1 5 2 1.95 1.04 1.05
Adult PE 9,942 3,988 18 105 58 55.57 21.04 1 33 4 7.07 7.09 0.65
Child PE 2,426 1,024 0 17 0 3.09 5.42 1 8 3 2.88 1.59 1.10
Adult SK 74,127 30,800 18 104 54 53.18 22.27 1 25 3 5.36 5.33 0.58
Child SK 22,164 9,036 0 17 0 2.60 5.01 1 6 2 2.18 1.25 1.04
Adult TE 7,302 2,932 18 102 40 43.31 18.30 1 16 3 3.81 3.36 0.54
Child TE 2,684 1,200 0 17 0 2.98 5.53 1 7 2 2.64 1.53 1.00

3. Most Frequent Hospitalizations Cohort

Cohort description

This cohort is created using CIHI’s Discharge Abstract Database (DAD) and the Ontario Mental Health Reporting System (OMHRS). The OMHRS contains records for patients admitted to the designated Adult inpatient mental health beds in the province of Ontario.

The inpatient DAD database and the OMHRS is used to count the total number of hospital discharges for each patient within each fiscal year.

Cohort selection: Most Frequent Hospitalization Users and Controls

The cohort was created by first stratifying by year, province (by patient residence), and age group Children (age < 18) and for Adults (age ≥18). Starting with the first hospitalization in the year, the number of hospitalizations was counted for each patient, and then the top 10% of most frequently hospitalized patients within each stratum was identified. Within each stratum, a control group is randomly selected from the 90% in the bottom deciles, using a sampling ratio of 4:1.

Time Frame and database for cohort selection

This cohort will initially cover the fiscal years of 2011-2012 to 2014-2015 inclusively. Each year the cohort selection process was/will be repeated, adding the patients for that fiscal year updating the data for all the patients previously selected. The dynamic nature of the cohort allows for the patients selected to be followed forward in time. Baseline data corresponding to the 2 years prior to the selection of the patient in the cohort is also available.

Exclusions

  1. Hospitalization records with gender = undefined or other
  2. Hospitalization records with an invalid/missing health card number or birthdate
  3. Hospitalization records with an invalid/missing admission date
  4. Hospitalization records with an invalid/missing discharge date
  5. Hospitalization records belonging to non-Canadian residents

Descriptive Statistics: Top 10% Most Frequent Hospitalizations (2014-2015)

    Total Population High User Cohort
Descriptive Stats: Age		 High User Cohort
Descriptive Stats: # Discharges		 Gender Analysis
Child
/
Adult		 Province Total # of unique patients in this pop # of High Users identified by Total Number of discharge Min Max Median Mean Std Dev Min Max Median Mean Std Dev Ratio M:F
Adult AB 230,849 49,940 18 106 63 60.33 20.69 2 26 2 2.61 1.17 0.87
Child AB 71,598 8,164 0 17 0 2.95 5.41 2 26 2 2.44 1.23 1.17
Adult BC 257,339 65,847 18 110 67 63.36 20.41 2 26 2 2.68 1.26 0.93
Child BC 56,582 6,310 0 17 0 3.96 6.04 2 19 2 2.46 1.19 1.20
Adult MB 75,940 17,708 18 105 65 60.84 21.61 2 25 2 2.61 1.14 0.77
Child MB 21,079 21,079 0 17 0 2.10 4.77 1 14 1 1.12 0.51 1.03
Adult NB 51,115 13,301 18 103 68 65.49 18.19 2 18 2 2.63 1.16 0.96
Child NB 10,654 10,654 0 17 0 2.71 5.10 1 35 1 1.15 0.67 1.06
Adult NL 33,101 8,176 18 102 66 62.97 18.58 2 21 2 2.60 1.17 0.94
Child NL 6,456 735 0 17 1 4.72 6.19 2 15 2 2.52 1.46 1.13
Adult NS 55,474 13,847 18 104 67 63.97 18.80 2 20 2 2.57 1.08 0.97
Child NS 11,639 1,201 0 17 0 4.10 6.04 2 22 2 2.52 1.48 1.15
Adult ON 702,908 160,474 18 108 68 64.32 19.64 2 33 2 2.63 1.20 0.93
Child ON 185,066 21,156 0 17 0 3.40 5.72 2 31 2 2.47 1.26 1.16
Adult PE 9,796 1,039 18 101 68 65.73 17.51 3 15 3 3.81 1.38 1.03
Child PE 2,217 273 0 17 0 3.59 5.76 2 11 2 2.37 1.00 1.37
Adult SK 76,753 7,836 18 104 69 65.24 19.92 3 32 3 3.94 1.59 0.91
Child SK 22,457 2,681 0 17 0 3.69 5.77 2 17 2 2.54 1.37 1.10
Adult TERR 7,223 1,820 18 101 53 51.60 19.71 2 23 2 2.69 1.31 0.89
Child TERR 2,860 403 0 17 0 4.05 6.02 2 11 2 2.41 0.97 1.41

Descriptive Statistics: Control Group – Hospitalizations (2014-2015)

    Population Control Cohort
Descriptive Stats: Age		 Control Cohort
Descriptive Stats: # Discharges		 Gender Analysis
Child/Adult Prov Total # of unique patients in this population # of Selected Controls for High Users identified by Total Number of Discharges Min Max Median Mean Std Dev Min Max Median Mean Std Dev Ratio M:F
Adult AB 230,849 162,747 18 104 45 48.74 20.51 1 1 1 1 0 0.52
Child AB 71,598 32,656 0 17 0 1.88 4.47 1 1 1 1 0 1.03
Adult BC 257,339 168,787 18 109 56 54.83 21.29 1 1 1 1 0 0.62
Child BC 56,582 25,240 0 17 0 1.93 4.56 1 1 1 1 0 1.07
Adult MB 75,940 51,391 18 108 52 52.15 21.77 1 1 1 1 0 0.55
Child MB 21,079                        
Adult NB 51,115 32,832 18 107 58 55.51 21.08 1 1 1 1 0 0.61
Child NB 10,654                        
Adult NL 33,101 22,099 18 105 58 55.25 20.19 1 1 1 1 0 0.64
Child NL 6,456 2,940 0 17 0 2.96 5.28 1 1 1 1 0 1.07
Adult NS 55,474 36,994 18 106 58 55.39 21.08 1 1 1 1 0 0.61
Child NS 11,639 4,804 0 17 0 2.25 4.89 1 1 1 1 0 1.01
Adult ON 702,908 487,749 18 108 55 54.03 21.40 1 1 1 1 0 0.56
Child ON 185,066 84,624 0 17 0 1.93 4.48 1 1 1 1 0 1.03
Adult PE 9,796 4,156 18 104 60 56.76 21.47 1 2 1 1.18 0.39 0.66
Child PE 2,217 1,092 0 17 0 2.60 5.00 1 1 1 1 0 1.11
Adult SK 76,753 31,344 18 104 53 52.88 22.13 1 2 1 1.18 0.38 0.59
Child SK 22,457 10,724 0 17 0 2.32 4.87 1 1 1 1 0 1.03
Adult TE 7,223 4,749 18 99 37 42.31 18.27 1 1 1 1 0 0.48
Child TE 2,860 1,612 0 17 0 2.93 5.50 1 1 1 1 0 1.00

Descriptive Statistics: Top 10% Most Frequent Hospitalizations (2013-2014)

    Total Population High User Cohort
Descriptive Stats: Age		 High User Cohort
Descriptive Stats: # Discharges		 Gender Analysis
Child
/
Adult		 Province Total # of unique patients in this pop # of High Users identified by Total Number of discharge Min Max Median Mean Std Dev Min Max Median Mean Std Dev Ratio M:F
Adult AB 225,793 49,832 18 108 63 59.95 20.69 2 27 2 2.62 1.17 0.86
Child AB 69,391 7,820 0 17 0 3.11 5.57 2 22 2 2.42 1.17 1.18
Adult BC 258,813 66,153 18 107 66 62.99 20.36 2 35 2 2.68 1.29 0.91
Child BC 57,094 6,385 0 17 0 4.27 6.24 2 23 2 2.46 1.23 1.13
Adult MB 74,520 17,583 18 104 64 60.48 21.43 2 25 2 2.63 1.21 0.77
Child MB 20,914 20,914 0 17 0 2.24 4.95 1 25 1 1.12 0.57 1.02
Adult NB 51,379 13,450 18 105 67 64.85 18.43 2 32 2 2.66 1.23 0.92
Child NB 10,640 1,079 0 17 0 4.28 6.09 2 24 2 2.51 1.46 1.15
Adult NL 33,249 8,094 18 102 65 61.62 18.95 2 23 2 2.66 1.32 0.92
Child NL 6,363 6,363 0 17 0 3.47 5.58 1 23 1 1.16 0.68 1.03
Adult NS 54,308 13,377 18 105 66 63.53 18.84 2 23 2 2.58 1.12 0.91
Child NS 11,942 1,230 0 17 0 4.21 6.00 2 20 2 2.57 1.57 1.06
Adult ON 694,235 157,764 18 110 67 63.92 19.57 2 32 2 2.62 1.20 0.93
Child ON 184,372 20,606 0 17 0 3.50 5.83 2 27 2 2.45 1.24 1.16
Adult PE 9,855 1,001 18 99 69 65.42 18.40 3 16 3 3.77 1.27 0.95
Child PE 2,283 264 0 17 0 4.69 6.38 2 9 2 2.48 1.10 1.03
Adult SK 75,907 7,668 18 104 69 65.21 19.79 3 24 3 3.93 1.57 0.91
Child SK 22,280 2,556 0 17 0 3.91 5.87 2 16 2 2.50 1.33 1.13
Adult TERR 7,209 1,793 18 100 53 51.45 19.72 2 18 2 2.72 1.34 0.82
Child TERR 2,940 370 0 17 0 3.85 5.83 2 9 2 2.45 1.03 1.10

Descriptive Statistics: Control Group – Hospitalizations (2013-2014)

    Population Control Cohort
Descriptive Stats: Age		 Control Cohort
Descriptive Stats: # Discharges		 Gender Analysis
Child/Adult Prov Total # of unique patients in this population # of Selected Controls for High Users identified by Total Number of Discharges Min Max Median Mean Std Dev Min Max Median Mean Std Dev Ratio M:F
Adult AB 225,793 162,295 18 108 45 48.79 20.56 1 1 1 1 0 0.52
Child AB 69,391 31,280 0 17 0 1.88 4.48 1 1 1 1 0 1.04
Adult BC 258,813 175,195 18 107 56 54.69 21.15 1 1 1 1 0 0.62
Child BC 57,094 25,540 0 17 0 2.06 4.69 1 1 1 1 0 1.04
Adult MB 74,520 51,617 18 108 51 51.79 21.84 1 1 1 1 0 0.53
Child MB 20,914                        
Adult NB 51,379 33,995 18 112 57 55.22 20.92 1 1 1 1 0 0.62
Child NB 10,640 4,316 0 17 0 2.44 4.93 1 1 1 1 0 1.05
Adult NL 33,249 22,911 18 107 57 54.88 19.85 1 1 1 1 0 0.65
Child NL 6,363                        
Adult NS 54,308 37,416 18 106 58 55.47 21.04 1 1 1 1 0 0.60
Child NS 11,942 4,920 0 17 0 2.32 4.89 1 1 1 1 0 1.00
Adult ON 694,235 494,991 18 109 54 53.79 21.33 1 1 1 1 0 0.55
Child ON 184,372 82,424 0 17 0 1.95 4.53 1 1 1 1 0 1.03
Adult PE 9,855 4,004 18 105 58 55.82 21.41 1 2 1 1.18 0.38 0.65
Child PE 2,283 1,056 0 17 0 3.03 5.46 1 1 1 1 0 1.02
Adult SK 75,907 30,672 18 104 54 53.13 22.18 1 2 1 1.18 0.38 0.58
Child SK 22,280 10,224 0 17 0 2.38 4.92 1 1 1 1 0 1.00
Adult TE 7,209 4,872 18 99 36 41.65 18.05 1 1 1 1 0 0.48
Child TE 2,940 1,480 0 17 0 2.84 5.42 1 1 1 1 0 1.05

Descriptive Statistics: Top 10% Most Frequent Hospitalizations (2012-2013)

    Total Population High User Cohort
Descriptive Stats: Age		 High User Cohort
Descriptive Stats: # Discharges		 Gender Analysis
Child
/
Adult		 Province Total # of unique patients in this pop # of High Users identified by Total Number of discharge Min Max Median Mean Std Dev Min Max Median Mean Std Dev Ratio M:F
Adult AB 219,345 48,571 18 105 63 60.06 20.68 2 33 2 2.61 1.19 0.84
Child AB 69,114 7,781 0 17 0 2.87 5.35 2 34 2 2.44 1.29 1.15
Adult BC 251,114 63,622 18 106 66 63.03 20.29 2 24 2 2.66 1.22 0.91
Child BC 58,122 6,562 0 17 0 3.98 6.04 2 21 2 2.43 1.08 1.16
Adult MB 75,073 17,804 18 106 64 60.37 21.52 2 16 2 2.64 1.20 0.78
Child MB 21,273 21,273 0 17 0 2.35 5.05 1 16 1 1.13 0.58 1.03
Adult NB 52,031 13,206 18 103 67 64.55 18.72 2 18 2 2.67 1.21 0.91
Child NB 11,195 11,195 0 17 0 2.90 5.19 1 23 1 1.14 0.64 1.05
Adult NL 33,674 8,184 18 102 64 61.79 18.73 2 24 2 2.66 1.35 0.90
Child NL 5,587 620 0 17 2 5.54 6.45 2 14 2 2.56 1.36 1.20
Adult NS 54,556 13,216 18 106 66 63.42 18.80 2 31 2 2.59 1.11 0.95
Child NS 12,336 1,276 0 17 0 4.36 6.16 2 19 2 2.57 1.60 1.14
Adult ON 690,928 155,154 18 106 67 63.65 19.64 2 39 2 2.61 1.18 0.92
Child ON 186,779 20,946 0 17 0 3.36 5.73 2 26 2 2.45 1.26 1.16
Adult PE 9,893 1,037 18 100 68 65.01 18.01 3 11 3 3.70 1.17 1.23
Child PE 2,234 295 0 17 1 4.70 6.19 2 20 2 2.57 1.57 1.11
Adult SK 74,572 7,705 18 108 70 65.61 20.14 3 25 3 3.89 1.49 0.90
Child SK 22,366 2,791 0 17 0 3.67 5.85 2 18 2 2.52 1.36 1.16
Adult TERR 7,374 1,920 18 96 53 51.65 19.26 2 15 2 2.72 1.31 0.84
Child TERR 2,848 390 0 17 0 4.37 6.33 2 13 2 2.47 1.21 0.97

Descriptive Statistics: Control Group – Hospitalizations (2012-2013)

    Population Control Cohort
Descriptive Stats: Age		 Control Cohort
Descriptive Stats: # Discharges		 Gender Analysis
Child
/
Adult		 Prov Total # of unique patients in this population # of Selected Controls for High Users identified by Total Number of Discharges Min Max Median Mean Std Dev Min Max Median Mean Std Dev Ratio M:F
Adult AB 219,345 162,567 18 107 46 48.99 20.76 1 1 1 1 0 0.52
Child AB 69,114 31,124 0 17 0 2.05 4.67 1 1 1 1 0 1.05
Adult BC 251,114 176,957 18 109 55 54.71 21.37 1 1 1 1 0 0.61
Child BC 58,122 26,248 0 17 0 2.02 4.61 1 1 1 1 0 1.05
Adult MB 75,073 53,998 18 110 51 51.91 21.95 1 1 1 1 0 0.55
Child MB 21,273                        
Adult NB 52,031 36,324 18 111 57 55.39 21.04 1 1 1 1 0 0.63
Child NB 11,195                        
Adult NL 33,674 24,089 18 105 57 54.98 20.07 1 1 1 1 0 0.65
Child NL 5,587 2,480 0 17 0 3.89 5.75 1 1 1 1 0 1.06
Adult NS 54,556 39,040 18 107 57 55.37 21.21 1 1 1 1 0 0.59
Child NS 12,336 5,104 0 17 0 2.47 5.00 1 1 1 1 0 1.03
Adult ON 690,928 510,169 18 114 54 53.76 21.39 1 1 1 1 0 0.56
Child ON 186,779 83,784 0 17 0 2.00 4.60 1 1 1 1 0 1.05
Adult PE 9,893 4,148 18 104 58 55.92 21.33 1 2 1 1.17 0.38 0.66
Child PE 2,234 1,180 0 17 0 3.19 5.46 1 1 1 1 0 0.97
Adult SK 74,572 30,820 18 106 54 53.29 22.38 1 2 1 1.18 0.38 0.58
Child SK 22,366 11,164 0 17 0 2.51 5.01 1 1 1 1 0 1.02
Adult TE 7,374 5,161 18 99 38 42.40 18.24 1 1 1 1 0 0.52
Child TE 2,848 1,560 0 17 0 3.00 5.49 1 1 1 1 0 0.95

Descriptive Statistics: Top 10% Most Frequent Hospitalizations (2011-2012)

    Total Population High User Cohort
Descriptive Stats: Age		 High User Cohort
Descriptive Stats: # Discharges		 Gender Analysis
Child
/
Adult		 Province Total # of unique patients in this pop # of High Users identified by Total Number of discharge Min Max Median Mean Std Dev Min Max Median Mean Std Dev Ratio M:F
Adult AB 214,959 47,208 18 106 62 59.81 20.70 2 37 2 2.61 1.20 0.84
Child AB 66,790 7,389 0 17 0 2.89 5.35 2 27 2 2.44 1.24 1.25
Adult BC 249,162 62,149 18 105 66 62.49 20.41 2 22 2 2.66 1.21 0.89
Child BC 58,274 6,392 0 17 0 3.82 5.90 2 24 2 2.46 1.21 1.19
Adult MB 75,796 18,438 18 102 64 60.28 21.65 2 18 2 2.67 1.26 0.74
Child MB 20,873 20,873 0 17 0 2.45 5.14 1 20 1 1.12 0.60 1.03
Adult NB 53,028 13,631 18 103 66 63.83 18.82 2 24 2 2.66 1.22 0.93
Child NB 11,656 1,216 0 17 1 4.47 6.08 2 13 2 2.43 1.10 1.14
Adult NL 33,916 8,271 18 105 64 61.53 18.96 2 22 2 2.64 1.32 0.88
Child NL 5,392 612 0 17 3 6.30 6.59 2 14 2 2.54 1.24 1.19
Adult NS 54,928 13,576 18 106 66 63.01 19.08 2 23 2 2.56 1.04 0.91
Child NS 12,742 1,368 0 17 0 4.04 6.03 2 18 2 2.51 1.46 1.19
Adult ON 682,032 151,058 18 109 67 63.30 19.60 2 46 2 2.60 1.17 0.92
Child ON 189,240 20,685 0 17 0 3.26 5.60 2 26 2 2.45 1.26 1.21
Adult PE 9,942 1,006 18 99 67 64.91 17.19 3 13 3 3.78 1.23 1.19
Child PE 2,426 294 0 17 0 4.31 6.42 2 11 2 2.51 1.12 1.31
Adult SK 74,127 7,759 18 107 70 65.41 20.01 3 26 3 3.92 1.55 0.90
Child SK 22,164 2,764 0 17 0 3.79 5.91 2 18 2 2.55 1.41 1.18
Adult TERR 7,302 1,751 18 98 52 51.23 19.94 2 15 2 2.71 1.29 0.80
Child TERR 2,684 376 0 17 0 4.11 6.29 2 7 2 2.39 0.78 1.25

Descriptive Statistics: Control Group – Hospitalizations (2011-2012)

    Population Control Cohort
Descriptive Stats: Age		 Control Cohort
Descriptive Stats: # Discharges		 Gender Analysis
Child
/
Adult		 Prov Total # of unique patients in this population # of Selected Controls for High Users identified by Total Number of Discharges Min Max Median Mean Std Dev Min Max Median Mean Std Dev Ratio M:F
Adult AB 214,959 167,751 18 107 47 49.54 20.89 1 1 1 1 0 0.53
Child AB 66,790 29,556 0 17 0 2.04 4.66 1 1 1 1 0 1.06
Adult BC 249,162 187,013 18 112 56 54.94 21.41 1 1 1 1 0 0.62
Child BC 58,274 25,568 0 17 0 2.04 4.63 1 1 1 1 0 1.07
Adult MB 75,796 57,358 18 107 52 52.48 22.07 1 1 1 1 0 0.55
Child MB 20,873                        
Adult NB 53,028 39,397 18 110 58 55.82 21.06 1 1 1 1 0 0.62
Child NB 11,656 4,864 0 17 0 2.88 5.19 1 1 1 1 0 1.02
Adult NL 33,916 25,645 18 104 57 55.16 19.96 1 1 1 1 0 0.66
Child NL 5,392 2,448 0 17 0 4.31 5.90 1 1 1 1 0 1.05
Adult NS 54,928 41,352 18 104 57 55.36 21.11 1 1 1 1 0 0.61
Child NS 12,742 5,472 0 17 0 2.57 5.11 1 1 1 1 0 1.02
Adult ON 682,032 530,974 18 112 54 53.98 21.40 1 1 1 1 0 0.56
Child ON 189,240 82,740 0 17 0 2.02 4.57 1 1 1 1 0 1.06
Adult PE 9,942 4,024 18 104 58 55.59 21.11 1 2 1 1.18 0.39 0.66
Child PE 2,426 1,176 0 17 0 3.16 5.52 1 1 1 1 0 0.99
Adult SK 74,127 31,036 18 105 54 53.65 22.42 1 2 1 1.18 0.39 0.58
Child SK 22,164 11,056 0 17 0 2.72 5.12 1 1 1 1 0 0.99
Adult TE 7,302 5,551 18 102 38 42.49 18.10 1 1 1 1 0 0.51
Child TE 2,684 1,504 0 17 0 2.95 5.50 1 1 1 1 0 1.01

4. Most Frequent Emergency Department (ED) Visits

Cohort description

This cohort is created using CIHI’s National Ambulatory Care Reporting System (NACRS). Only ED records submitted by Ontario and Alberta to the National Ambulatory Care Reporting System (NACRS) are included.

We will use the NACRS to count the total number of emergency department visits for each patient within each fiscal year.

Cohort selection: Most Frequent Emergency Department Users and Controls

The cohort was created by first stratifying by year, province (by patient residence), and age group Children (age < 18) and for Adults (age ≥18). Starting with the first ED visit in the year, the number of ED visits was counted, and then the top 10% of most frequent ED visitors within each stratum was identified. Within each stratum, a control group is randomly selected from the 90% in the bottom deciles, using a sampling ratio of 4:1.

Time Frame for cohort selection

This cohort will initially cover the fiscal years of 2011-2012 to 2014-2015 inclusively. Each year the cohort selection process will be repeated, adding the patients for that fiscal year updating the data for all the patients previously selected. The dynamic nature of the cohort allows for the patients selected to be followed forward in time. Baseline data corresponding to the 2 years prior to the selection of the patient in the cohort is also available.

Exclusions

  1. ED records with gender = undefined or other
  2. ED records with an invalid/missing health card number or birthdate
  3. ED records belonging to non-Canadian residents

Descriptive Statistics: Top 10% Most Frequent ED Visitors (2014-2015)

    Total Population High User Cohort
 Descriptive Stats: Age		 High User Cohort
Descriptive Stats: # Discharges		 Gender Analysis
Child
/
Adult		 Province Total # of unique patients in this population # of High Users identified by Total Number of Discharges Min Max Median Mean Std Dev Min Max Median Mean Std Dev Ratio M:F
Adult AB 841,346 103,757 18 106 46 48.07 20.74 4 466 5 6.77 6.63 0.82
Child AB 288,386 53,365 0 17 5 6.78 5.72 3 57 4 4.23 2.09 1.10
Adult ON 2,572,057 467,738 18 110 51 52.03 21.62 3 502 4 4.61 3.54 0.79
Child ON 694,254 100,351 0 17 5 6.93 5.78 3 101 3 4.05 1.87 1.06

Descriptive Statistics: Control Group – ED Visitors (2014-2015)

    Population Control Cohort
Descriptive Stats: Age		 Control Cohort
Descriptive Stats: # Discharges		 Gender Analysis
Child/Adult Prov Total # of unique patients in this population # of Selected Controls for High Users identified by Total Number of ED Visits Min Max Median Mean Std Dev Min Max Median Mean Std Dev Ratio M:F
Adult AB 841,346 415,028 18 114 43 45.55 18.71 1 3 1 1.40 0.65 0.97
Child AB 288,386 192,503 0 17 7 7.30 5.51 1 2 1 1.25 0.43 1.13
Adult ON 2,572,057 1,755,350 18 128 49 49.10 19.59 1 2 1 1.23 0.42 0.91
Child ON 694,254 401,404 0 17 7 7.68 5.57 1 2 1 1.22 0.42 1.15

Descriptive Statistics: Top 10% Most Frequent ED Visitors (2013-2014)

    Total Population High User Cohort
Descriptive Stats: Age		 High User Cohort
Descriptive Stats: # Discharges		 Gender Analysis
Child
/
Adult		 Province Total # of unique patients in this population # of High Users identified by Total Number of Discharges Min Max Median Mean Std Dev Min Max Median Mean Std Dev Ratio M:F
Adult AB 825,554 102,403 18 105 45 47.75 20.63 4 420 5 6.81 6.51 0.80
Child AB 279,999 51,780 0 17 5 6.79 5.77 3 54 4 4.23 2.06 1.10
Adult ON 2,512,160 453,353 18 109 51 51.57 21.46 3 549 4 4.61 3.89 0.79
Child ON 673,778 94,331 0 17 5 7.01 5.83 3 66 3 4.02 1.77 1.06

Descriptive Statistics: Control Group – ED Visitors (2013-2014)

    Population Control Cohort
Descriptive Stats: Age		 Control Cohort
Descriptive Stats: # Discharges		 Gender Analysis
Child
/
Adult		 Prov Total # of unique patients in this population # of Selected Controls for High Users identified by Total Number of ED Visits Min Max Median Mean Std Dev Min Max Median Mean Std Dev Ratio M:F
Adult AB 825,554 409,612 18 127 43 45.27 18.65 1 3 1 1.42 0.65 0.97
Child AB 279,999 195,241 0 17 7 7.38 5.50 1 2 1 1.25 0.43 1.13
Adult ON 2,512,160 1,798,793 18 128 48 48.83 19.52 1 2 1 1.24 0.43 0.90
Child ON 673,778 377,324 0 17 7 7.72 5.56 1 2 1 1.22 0.42 1.16

Descriptive Statistics: Top 10% Most Frequent ED Visitors (2012-2013)

    Total Population High User Cohort
 Descriptive Stats: Age		 High User Cohort
Descriptive Stats: # Discharges		 Gender Analysis
Child
/
Adult		 Province Total # of unique patients in this population # of High Users identified by Total Number of Discharges Min Max Median Mean Std Dev Min Max Median Mean Std Dev Ratio M:F
Adult AB 800,823 101,502 18 105 45 47.66 20.70 4 422 5 6.86 6.83 0.80
Child AB 278,464 53,951 0 17 5 6.78 5.80 3 63 4 4.28 2.19 1.11
Adult ON 2,477,466 448,578 18 107 50 51.36 21.40 3 498 4 4.60 3.72 0.80
Child ON 678,782 97,793 0 17 5 7.02 5.87 3 54 3 4.04 1.80 1.09

Descriptive Statistics: Control Group – ED Visitors (2012-2013)

    Population Control Cohort
Descriptive Stats: Age		 Control Cohort
Descriptive Stats: # Discharges		 Gender Analysis
Child/Adult Prov Total # of unique patients in this population # of Selected Controls for High Users identified by Total Number of ED Visits Min Max Median Mean Std Dev Min Max Median Mean Std Dev Ratio M:F
Adult AB 800,823 406,008 18 107 43 45.25 18.79 1 3 1 1.43 0.66 0.96
Child AB 278,464 205,392 0 17 7 7.44 5.51 1 2 1 1.26 0.44 1.13
Adult ON 2,477,466 1,794,312 18 126 48 48.67 19.61 1 2 1 1.24 0.43 0.90
Child ON 678,782 391,172 0 17 7 7.77 5.57 1 2 1 1.23 0.42 1.16

Descriptive Statistics: Top 10% Most Frequent ED Visitors (2011-2012)

    Total Population High User Cohort
 Descriptive Stats: Age		 High User Cohort
Descriptive Stats: # Discharges		 Gender Analysis
Child
/
Adult		 Province Total # of unique patients in this population # of High Users identified by Total Number of Discharges Min Max Median Mean Std Dev Min Max Median Mean Std Dev Ratio M:F
Adult AB 762,230 97,774 18 105 45 47.63 20.69 4 481 5 6.92 6.86 0.81
Child AB 265,966 51,071 0 17 5 6.93 5.82 3 57 4 4.29 2.16 1.11
Adult ON 2423,795 436,656 18 109 50 50.92 21.30 3 336 4 4.61 3.70 0.80
Child ON 695,202 101,415 0 17 5 7.11 5.84 3 111 3 4.04 1.83 1.10

Descriptive Statistics: Control Group – ED Visitors (2011-2012)

    Population Control Cohort
Descriptive Stats: Age		 Control Cohort
Descriptive Stats: # Discharges		 Gender Analysis
Child/Adult Prov Total # of unique patients in this population # of Selected Controls for High Users identified by Total Number of ED Visits Min Max Median Mean Std Dev Min Max Median Mean Std Dev Ratio M:F
Adult AB 762,230 391,096 18 112 43 45.25 18.98 1 3 1 1.45 0.68 0.96
Child AB 265,966 204,284 0 17 7 7.47 5.54 1 2 1 1.27 0.44 1.14
Adult ON 2,423,795 1,746,624 18 112 47 48.54 19.74 1 2 1 1.25 0.44 0.89
Child ON 695,202 405,660 0 17 7 7.80 5.56 1 2 1 1.24 0.43 1.17
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