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Back To Vidyya Heart Disease And Stroke Leading Cause Of Hospitalization

Reports Canadian Institute For Health Information

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 to strokes.

These statistics come from CIHI's Hospital Morbidity Database, a national comprehensive source of information on in-patient hospitalization by disease category.

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, respectively.

"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 men."

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.

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Editor: Susan K. Boyer, RN
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