Discharge Abstracts Database (Hospital Separations) data set

Description

Data on discharges, transfers and deaths of in-patients and day surgery patients from acute care hospitals in BC.

All Canadian hospitals (except those in Quebec) submit their separations records directly to the Canadian Institute of Health information (CIHI) for inclusion in the Discharge Abstract Database (DAD). The database contains demographic, administrative and clinical data for hospital discharges (inpatient acute, chronic, rehabilitation) and day surgeries. A provincial data set, including various CIHI value-added elements (such as case mix groups, and resource intensity weights) is released on a monthly basis to the respective Ministries of Health. The DAD data files which Population Data BC receives include the CIHI variables. Population Data BC receives these data once per year.

Variables available

Both Core and Non-Core fields are available for this data set.

Core vs. Non-Core Data

• Core Data: Some BC Ministry of Health data sets available through PopData and HDPBC are called ‘Core Data’. A Core Data set is a standardized ‘bundle’ of commonly requested variables. A Core Data set may not include ALL the variables available in the data set. For example, some Core Data variables, such as geography or organisational codes, are suppressed to meet privacy legislation requirements.
• Non-Core Data: Non-Core Data are variables that are NOT included in the standardized Core Data set. Non-Core Data is available for request as an addition to the Core Data set.

For the majority of DARs, requesting access to Core Data ONLY may make the data access approval process quicker and may expedite data provision. Data requests that include Non-Core Data will be subject to regular rather than expedited processes, both for application review and data provisioning.

Please note that the overall data access request is subject to meeting ALL of the Five SAFEs requirements. For more detail on the Five SAFEs, visit the Eligibility and the Five SAFES model page of our website.

> download Discharge Abstracts Database (DAD) (Hospital Separations) all available variables (pdf)

Data update schedule

For BC, our Discharge Abstracts Database usually has a 6-month lag. 

Approximate data update schedule	Complete data up to:
January	June 30th
April	September 20th
July	December 31st
October	March 31st

Please note: Our data update schedule depends on when these data are made available to us by the data provider, so the update schedule is an estimation only. 

Inclusions

• Discharges, transfers and deaths of in-patients and day surgery patients (e.g. those undergoing scope procedures, cataract procedures, or other procedures requiring operating room time) from acute care hospitals.
• Data on BC residents who are admitted to a hospital in another province or territory are included in the DAD data. Also included in the data files are data on non-BC residents who are admitted to a BC hospital, however these data are usually excluded from extractions for research projects.
• The data include some records indicating the level of care is "extended". For the most part, these records refer to people who are in long-term care facilities that are attached to an acute care facility and should be excluded from analyses.

Exclusions

• Data on abortion procedures, including those conducted in concert with other procedures, are only available by special request. Requests must demonstrate how Therapeutic Abortion (TA) data is required to fulfill the research objectives by providing a strong rationale. The Ministry of Health will review requests and make a decision on release according to existing policy on a case-by-case basis. This is in accordance with the BC Freedom of Information and Protection of Privacy Act article 22.1.
• Visits to emergency rooms/departments are not recorded in the hospital files, though admissions to acute care via the emergency room are noted in the "entry code" field. The report by McKendry et al, 2002 provides more information on various methods for identifying emergency users.
• Outpatient services like x-rays or blood work are not included in the hospital data.

Quality/accuracy of information/field coding source

The centralized data processing of the DAD records done by the Canadian Institute of Health information (CIHI) results in increased efficiency and standardization among the participating provinces.

Data changes over time

• Beginning in 1996/97, the mother's personal health number (PHN) was recorded on a baby's discharge record, so it became possible to link mothers and babies in the hospital files.
• The format of the data changed significantly in 2001/02. Part of this change was due to the switch in BC from coding diagnoses in ICD9 codes to ICD10-CA codes, and from coding procedures/interventions in CCP procedure codes to CCI intervention codes. Beginning in 2001/02, some of the data fields have different names but the same meaning, and some fields may have the same name but contain subtly different data. Population Data BC has standardized the data fields and names across the years where possible.
• From 2001/02 to 2006/07, i.e. until all provinces in Canada were coding in ICD10-CA and CCI, CIHI was providing both the originally coded diagnosis codes and intervention codes (i.e. ICD10-CA and CCI for BC) and back-coded versions of these codes (i.e. ICD9/CCP codes) in the DAD files. This stopped as of 2007/08.
• Also as of April 2007, CIHI has redeveloped its acute care inpatient grouping methodology. The new CMG+ methodology is built on ICD10-CA/CCI activity and cost data and replaces the CMG/Plx methodology. CMG+ takes advantage of the increased specificity of the ICD10-CA/CCI classification standards and features several modifications and enhancements.

Important additional information

These data files are grouped into fiscal years by separation date, not the date of admission.

References

• Several references are available on the CIHI web site (www.cihi.ca) on the impact of CIHI's acute-care inpatient grouping methodology switch, including "Coping with the Introduction of ICD10-CA and CCI: Impact of New Classifications Systems on the Assignment of Case Mix Groups/Day Procedure Groups using Fiscal 2001/2002 Data" and "CMG+ Tool Kit: Transitioning to the new CMG+ Grouping Methodology".
• McKendry R, Reid RJ, McGrail KM, Kerluke KJ. Emergency Rooms in British Columbia: A pilot project to Validate Current Data and Describe Users. Vancouver (BC): Centre for Health Services and Policy Research; December 2002.
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