Canada's number one killer, heart disease and stroke, was the leading cause of hospitalization in Canada in 1998/99. Heart disease and stroke accounted for 15% of all discharges and 19% of all patient days, according to new statistics released today by the Canadian Institute for Health Information (CIHI).
Heart disease and stroke also played an even bigger role in
hospitalizations among the elderly (age 65 and over) accounting for 28% of all
discharges in this age group. "As a population, we need to better promote
strategies for a healthier lifestyle, stop smoking and generally reduce our
risk factors for heart disease and stroke," says Dr. John Millar, a medical
advisor and CIHI's Vice-President of Research.
For the fifth consecutive year, the total number of in-patient discharges
from Canadian acute care hospitals has declined. There were almost 3 million
hospital discharges in 1998/99, 1% less than 1997/98 and 11% less than the 3.4
million discharges just four years ago.
The discharge rate (which is one measure of Canada's in-patient hospital
use) showed a similar trend, dropping 2% from the previous year and 16% since
1994/95. "Among the reasons for the decline in acute in-patient hospital use
are improved medical technologies and treatments, improved techniques in
anaesthesia and new pharmaceuticals. This means that more operations can now
be performed on a day surgery or out-patient basis where patients stay for
only a few hours before going home," adds Dr. Millar.
The discharge rate for heart attacks and strokes followed the national
trend, showing a 4% decline in rates between 1994/95 and 1998/99 for
discharges due to heart attacks and an almost 11% decline for discharges due
These statistics come from CIHI's Hospital Morbidity Database, a national
comprehensive source of information on in-patient hospitalization by disease
Since 1994/95, there has been a steady decline in a patient's average
length of stay in hospital, from 7.4 days to 7.0 days in 1998/99. The average
time spent in hospitals for patients with heart disease and stroke also
declined, dropping from 9.7 days to 8.6 days during the same period.
Heart disease and stroke was the leading cause of hospitalization among
men in all age groups, representing over 20% of all discharges for men in
1998/99. For women, heart disease and stroke was second only to pregnancy and
childbirth as a reason for hospitalization.
In 1998/99, men were more than twice as likely to be hospitalized due to
heart attacks than women, with rates of 263 and 108 per 100,000 population
respectively. Men were also almost one and a half times more likely to be
hospitalized due to strokes than women, with rates of 239 and 167,
"This gender gap has been consistent over the last five years," explains
Greg Webster, Clinical Epidemiologist and Manager of Clinical Registries at
CIHI. "Another consistent difference is that there are more heart attacks than
strokes among men and more strokes than heart attacks among women. However,
when admitted for either condition, women spent more time in hospital than
When women were admitted for heart attacks in 1998/99, their average
length of stay was 9.2 days compared to 7.8 for men. For strokes, the average
length of stay was 16.0 for women and 13.8 for men.
All provinces and territories, except Manitoba, Prince Edward Island and
the Northwest Territories, showed a decline in the discharge rate in 1998/99
compared to the previous year. The largest declines occurred in British
Columbia and Saskatchewan. Since 1994/95, discharge rates in all provinces
have declined by at least 7%.
For a second year in a row, Ontario had the lowest discharge rate in
1998/99 at 8,786 per 100,000 population, followed by Quebec (9,147) and
British Columbia (9,453). As in the previous year, the Northwest Territories
recorded the highest discharge rate of 14,619 per 100,000 followed by New
Brunswick (13,983) and Saskatchewan (13,341).
A hospital discharge is the release or death of an in-patient (a person
admitted to hospital). While discharge data describe and measure the changing
case flow and workload within hospitals over time, they do not indicate the
number of individuals using hospital services. For example, an individual
could be included several different times in annual discharge totals.
The rates in this release are age-standardized which removes the effect
of age. All figures refer to acute in-patient events only and exclude newborns
and patients treated in other types of care such as emergency wards, chronic
care and rehabilitation units and day surgery programs.