Self-Harm Hospitalizations
Lower rates are desirable as they signal less frequent severe self-harm.
The indicator captures both suicidal and non-suicidal self-harm within the hospitalization data where intentional self-harm was noted in the medical chart or abstract by a physician. Injuries coded as accidental or undetermined are not included in this indicator, even though a portion of these injuries may have been intentional. As such, this indicator underestimates the true number of hospitalizations for self-harm and should be considered a minimum rate of self-harm.
(Total number of discharges for self-harm for patients age 10 and older ÷ Total mid-year population age 10 and older) × 100,000 (age-adjusted)
Total mid-year population age 10 and older
Total number of self-harm hospitalizations for persons age 10 and older.
Unit of analysis for numerator cases: Episode of care. Episode building was performed among Discharge Abstract Database–Hospital Morbidity Database (DAD-HMDB) records to accommodate multiple abstracts within a single episode of care.
An episode of care refers to all contiguous inpatient hospitalizations in general and psychiatric hospitals. For episodes with transfers within or between facilities, transactions were linked regardless of diagnoses. To construct an episode of care, a transfer is assumed to have occurred if either of the following conditions is met:
- An acute care hospitalization occurs less than 7 hours after discharge from the previous acute care hospitalization, regardless of whether the transfer is coded;
- An acute care hospitalization occurs between 7 and 12 hours after discharge from the previous acute care hospitalization, and at least one of the hospitalizations has coded the transfer.
Methodology
Name
Self-Harm Hospitalizations
Short/Other Names
Not applicable
Description
Age-standardized rate of hospitalizations in a general or psychiatric hospital due to self-harm, per 100,000 population age 10 and older.
For further details, please see the General Methodology Notes (PDF).
Rationale
Self-harm is defined as a deliberate bodily injury or poisoning that may or may not result in death. This type of injury is the result of either suicidal or self-harming behaviours, or both. Self-harm can be prevented, in many cases, by early recognition, intervention and treatment of mental disorders. While some risk factors for self-harm are beyond the control of the health system, high rates of self-harm hospitalizations can be interpreted as the result of a failure of the system to prevent self-harms that are severe enough to require hospitalization.
Interpretation
Lower rates are desirable as they signal less frequent severe self-harm.
The indicator captures both suicidal and non-suicidal self-harm within the hospitalization data where intentional self-harm was noted in the medical chart or abstract by a physician. Injuries coded as accidental or undetermined are not included in this indicator, even though a portion of these injuries may have been intentional. As such, this indicator underestimates the true number of hospitalizations for self-harm and should be considered a minimum rate of self-harm.
HSP Framework Dimension
Health system outcomes: Improve health status of Canadians
Areas of Need
Not applicable
Targets/Benchmarks
Not applicable
Available Data Years
to (fiscal years)
Geographic Coverage
- All provinces/territories
Reporting Level/Disaggregation
- National
- Province/Territory
- Region
- Neighbourhood Income Quintile
- Sex
Indicator Results
Update Frequency
Every year
Latest Results Update Date
Updates
Not applicable
Description
(Total number of discharges for self-harm for patients age 10 and older ÷ Total mid-year population age 10 and older) × 100,000 (age-adjusted)
Type of Measurement
Rate - Rate: per 100,000
Denominator
Description:
Total mid-year population age 10 and older
Numerator
Description:
Total number of self-harm hospitalizations for persons age 10 and older.
Unit of analysis for numerator cases: Episode of care. Episode building was performed among Discharge Abstract Database–Hospital Morbidity Database (DAD-HMDB) records to accommodate multiple abstracts within a single episode of care.
An episode of care refers to all contiguous inpatient hospitalizations in general and psychiatric hospitals. For episodes with transfers within or between facilities, transactions were linked regardless of diagnoses. To construct an episode of care, a transfer is assumed to have occurred if either of the following conditions is met:
- An acute care hospitalization occurs less than 7 hours after discharge from the previous acute care hospitalization, regardless of whether the transfer is coded;
- An acute care hospitalization occurs between 7 and 12 hours after discharge from the previous acute care hospitalization, and at least one of the hospitalizations has coded the transfer.
Inclusions:
- Admission to hospital with self-harm diagnosis (ICD-10-CA codes X60 to X84) for those age 10 and older, sex recorded as male or female
- Analytical Institution Type Code = 1 (general hospital) or 5 (psychiatric hospital) from the DAD
- Ontario Mental Health Reporting System (OMHRS) records for cases where the OMHRS stay was from an initial emergency department (ED) visit for intentional self-harm (X60 to X84 in the National Ambulatory Care Reporting System [NACRS]) within 7 days
Additional notes on the inclusions:
- At this time, we are unable to determine the rate for those not identified as male or female in the data.
Exclusions:
- Cadaveric donor or stillbirth records (Admission Category Code = R or S)
- 2018–2019 data onward: Medical assistance in dying (MAID) (Discharge Disposition Code = 73)
Method of Adjustment
Direct standardization
Standard Population:
Canada 2011
Adjustment Applied
Age-adjusted
Geographic Assignment
Place of residence
Data Sources
- DAD
- HMDB
- NACRS
- OMHRS
Caveats and Limitations
The indicator captures only cases within the hospitalization data where intentional self-harm was noted in the medical chart or abstract by a physician. This indicator does not include cases of self-harm that are not admitted to hospital, nor injuries coded as accidental or undetermined, even though a portion of these injuries may have been intentional. In addition, self-harm where no medical care is sought (including deaths by suicide in the community) or where a patient visits only a primary health care provider or emergency department will not be captured. Thus, this indicator underestimates the true number of hospitalizations for self-harm and should be considered a minimum rate of self-harm .
References
Not applicable
How to cite:
Canadian Institute for Health Information. Self-Harm Hospitalizations. Accessed October 22, 2024.
If you would like AVÐÇÇò information in a different format, visit our Accessibility page.
Comments
Patients in the Discharge Abstract Database–Hospital Morbidity Database (DAD-HMDB) and OMHRS with invalid postal codes will not be included in the numerator of any province but will be included in the all-Canada numerator. An exception to this is patients who are identified as homeless (DAD-HMDB: diagnosis code = Z59.0 or postal code = XX; OMHRS: residential status code = 8); these patients will be assigned to the province of the facility.