Concept: Health Indicators: Indicators of Health Status and Healthcare Use

Introduction

This concept provides a list of health indicators of health status and healthcare use that are used in MCHP research to measure and compare the health of Manitobans across regions. The majority of information in this concept comes from The 2013 RHA Indicators Atlas deliverable. The indicators are listed under several different categories, and provide a link to more detailed concepts and glossary terms that are available on the MCHP web site. At the end of each section, links are provided to detailed information in the relevant sections of multiple MCHP deliverables. Additional links provide access to available "Data Extras" for these reports that provide access to tables and graphs not available within the report itself.

Health Indicator Categories

The health indicators developed for the 2013 RHA Indicators Atlas are presented in ten broad categories*:

1. Demographics
   
2. Population Health Status and Mortality
   
3. Physical Illness
   
   1. Chronic Physical Illness
   2. Adverse Health Event Rates
4. Mental Illness
   
5. Physician Services
   
6. Hospital Services
   
7. High Profile Surgical and Diagnostic Services
   
8. Use of Personal Care Homes (PCHs)
   
9. Immunizations and Prescription Drug Use / Other Preventative Services
   
10. Quality of Primary Care

Specific indicators are listed under each broad category, with either a brief description of what was calculated, or with a link to a concept and/or glossary term that describes more about the indicator and how the rate was calculated. Most of the indicators were calculated using a population-based approach. This means that the rates or prevalence shown in the Atlas are based upon virtually every person in Manitoba.

*Please note: Some categories also include health indicators from the Manitoba RHA Indicators Atlas 2009, the Profile of Metis Health Status and Healthcare Utilization in Manitoba: A Population-Based Study and the Health and Healthcare Utilization of Francophones in Manitoba deliverables. In these cases, indicators are marked with an asterisk (*).

1. Demographics

• Population Pyramids
  
• Socioeconomic Factor Index (SEFI) - Version 2 (SEFI-2) (Glossary Term); Socioeconomic Factor Index (SEFI) - Version 2 (SEFI-2) (Concept) - SEFI-2 is calculated at the geographic level of the dissemination area and is then assigned to residents based on their postal codes.
  
• Social and Material Deprivation

LINKS:
• The 2013 RHA Indicators Atlas (pdf) - Demographics
  • Demographics Data Extras

2. Population Health Status and Mortality

• Total Mortality Rate
  
• Causes of Death - a measure of the distribution or frequency of cause of death based on five years of Vital Statistics mortality data.
  
• Premature Mortality Rate (PMR)
  
• Causes of Premature Death
  
• Life Expectancy at Birth* - the average number of years an individual of a given age is expected to live if current age-sex-specific mortality rates remain stable.
  
• Male Life Expectancy
  
• Female Life Expectancy
  
• Potential Years of Life Lost (PYLL) - for each death, the PYLL value is calculated as: PYLL = 75 - age at death. The denominator includes all Manitoba residents 1 to 74 years old.
  
• Suicide Rates
  
• Suicide or Suicide Attempt* - this indicator measures the proportion of the population that committed or attempted suicide.
  
• Suicide or Suicide Attempt Prevalence*
  
• Total Mortality by Cause & Injury Mortality by Cause* - the most frequent (10+) causes of total mortality for Manitobans were reported for five calendar years, 2002-2006.
  
• All Cause Five-Year Mortality Rates for Individuals with Diabetes*
  
• All Cause Five-Year Mortality Rates for Individuals with Cumulative Mental Illness*

LINKS:
• The 2013 RHA Indicators Atlas (pdf) - Population Health Status and Mortality
  
  • Mortality Data Extras
• Profile of Metis Health Status and Healthcare Utilization in Manitoba: A Population-Based Study (pdf) - Population Health Status and Mortality
  • Population Health Status and Mortality Data Extras - (Metis)

3a. Physical Illness: Chronic Physical Illness

• Hypertension Prevalence - the percent of residents aged 19 and older with hypertension (high blood pressure) in a one-year period.
  
• Hypertension Incidence - the average number of new cases of residents aged 19 and older with hypertension (high blood pressure) per 100 person-years.
  
• Arthritis Prevalence - the percent of residents aged 19 and older with arthritis (rheumatoid or osteo-arthritis) in a two-year period.
  
• Total Respiratory Morbidity (TRM) Prevalence - the percent of residents (all ages) with a respiratory disease (asthma, chronic or acute bronchitis, emphysema, or chronic airway obstruction) in a one-year period.
  
• Diabetes Prevalence - the percent of residents aged 19 and older with diabetes (type 1 or 2) in a three-year period.
  
• Diabetes Incidence - the average number of new cases of residents aged 19 and older with diabetes (Type I and II) per 100 person-years.
  
• Ischemic Heart Disease (IHD) Prevalence - the percent of residents aged 19 and older with ischemic heart disease (IHD) in a five-year period.
  
• Ischemic Heart Disease (IHD) Incidence - the average number of new cases of residents aged 19 and older with ischemic heart disease (IHD) per 100 person-years.
  
• Congestive Heart Failure (CHF) Prevalence - the percent of residents aged 40 and older with congestive heart failure in a three-year period.
  
• Osteoporosis Prevalence - the percent of residents aged 50 and older with osteoporosis in a three-year period.

LINKS:
• The 2013 RHA Indicators Atlas (pdf) - Chronic Physical Illness
  • Physical Illness Data Extras

3b. Physical Illness: Adverse Health Event Rates

• Acute Myocardial Infraction (AMI) Rates
  
• Stroke Rates
  
• Lower Limb Amputation Among Residents with Diabetes
  
• Dialysis Initiation*

LINKS:
• 2013 Health Indicators Atlas (pdf) - Adverse Health Event Rates
  • Physical Illness Data Extras
• Health and Healthcare Utilization of Francophones in Manitoba (pdf) - Prevalence of Physical Illness

4. Mental Illness

• Mood and Anxiety Disorder Prevalence - the percent of residents aged 10 and older with mood and anxiety disorders in two 5-year periods.
  
• Substance Abuse Prevalence - the percent of residents aged 10 and older with substance abuse over two 5-year periods.
  
• Dementia Prevalence - the percent of residents aged 55 and older with dementia, including organic psychotic conditions, cerebral degenerations, and senility, over two 5-year periods.
  
• Cumulative Mental Health Disorders* - an overall indicator of the prevalence of mental illness and accounts for the co-occurrence among mental illnesses. Cumulative prevalence was defined as the proportion of the population who received treatment for any of the following: depression, anxiety, substance abuse, personality disorders, or schizophrenia.
  
• Depression*
  
• Anxiety*
  
• Personality Disorders*
  
• Schizophrenia*

LINKS:
• The 2013 RHA Indicators Atlas (pdf) - Mental Illness
  • Mental Illness Data Extras
• The Manitoba RHA Indicators Atlas 2009 (pdf) - Mental Illness
  • Mental Illness Data Extras (2009)

5. Physician Services

• Use of Physicians - the percentage of residents who see a physician at least once over the course of a year gives an indication of the accessibility of ambulatory care for local residents.
  
• Ambulatory Visits
  
• Ambulatory Consultation*
  
• Ambulatory Visits by Age and Sex - the average number of visits to physicians by resident age and sex in a given year.
  
• Ambulatory Visits to Specialists* - the average number of ambulatory visits (including consultations) made to specialist physicians per resident per year.
  
• Causes of Physician Visits - the top five or ten causes of physician visits.
  
• Ambulatory Consultation Rates
  
• Majority of Care - a measure of whether individuals receive most of their ambulatory care (> 50%) from a single provider.
  
• Location of Visits to General and Family Practitioners
  
• Location of Visits to Specialists
  
• Continuity of Care*
  
• Use of Physicians with Capacity to Offer Services in French*

LINKS:
• 2013 RHA Indicators Atlas (pdf) - Physician Services
  • Physical Services Data Extras
• The Manitoba RHA Indicators Atlas 2009 (pdf) - Physician Services
  • Physician Services Data Extras (2009)
• Health and Healthcare Utilization of Francophones in Manitoba (pdf) - Use of Physician Services

6. Hospital Services

• Hospital Bed Supply - the values provide an overall indication of the relative supply of beds across the province, and can track major changes over time. This number is often expressed per 1000 residents.
  
• Use of Hospitals - a measure of the accessibility of hospital care for local residents.
  
• Inpatient Hospitalization - the top five to ten causes of hospitalization.
  
• Day Surgery
  
• Hospital Days Used in Short Stays (1-29 days)*
  
• Hospital Days Used in Short Stays (1-13 days)
  
• Hospital Days Used in Long Stays (14+ days)
  
• Hospital Days Used in Long Stays (30+ days)*
  
• Causes of Hospitalization - the top five to ten causes of hospitalization.
  
• Causes of Hospital Days Used - the most frequent causes of hospital days used for each Regional Health Authority (RHA) and the province overall.
  
• Hospital Readmission
  
• Factors Associated With Readmission
  
• Hospitalization Rates for Ambulatory Care Sensitive (ACS) Conditions
  
• Hospital Location: Where RHA Residents Were Hospitalized - Hospitalizations
  
• Hospital Location: Where RHA Residents Were Hospitalized - Days
  
• Hospital Catchment: Where Patients Using RHA Hospitals Came From - Hospitalizations
  
• Hospital Catchment: Where Patients Using RHA Hospitals Came From - Days
  
• Hospital Location
  
• Hospital Separation (Discharge)*
  
• Hospitalization for Injury*
  
• Causes of Injury Hospitalization* - the most frequent causes of hospitalization due to injury for Manitobans.

LINKS:
• 2013 RHA Indicators Atlas (pdf) - Hospital Services
  • Hospital Services Data Extras
• The Manitoba RHA Indicators Atlas 2009 (pdf) - Hospital Services
  • Hospital Services Data Extras (2009)

7. High Profile Surgical and Diagnostic Services

• Cardiac Catheterization (Diagnostic Angiogram)
  
• Percutaneous Coronary Interventions (PCI)
  
• Angioplasty
  
• Stent Insertion
  
• Coronary Artery Bypass Surgery
  
• Total Hip Replacement
  
• Total Knee Replacement
  
• Cataract Surgery
  
• Dental Extractions Among Young Children
  
• Computed Tomography (CT) Scans
  
• Magnetic Resonance Imaging (MRI) Scans
  
• Caesarean / Cesarean Section (C-Section) - (Concept); Caesarean / Cesarean Section (C-Section)* - (Glossary Definition)
  
• Hysterectomy* - (Concept); Hysterectomy* - (Glossary Definition)
  
• Transurethral Resection of the Prostate (TURP)*

LINKS:
• The 2013 RHA Indicators Atlas (pdf) - High Profile Surgical and Diagnostic Services
  • Surgical and Diagnostic Services Data Extras
• Profile of Metis Health Status and Healthcare Utilization in Manitoba: A Population-Based Study (pdf) - High Profile Surgical and Diagnostic Services
  • High Profile Surgical and Diagnostic Services Data Extras (Metis)
• The Manitoba RHA Indicators Atlas 2009 (pdf) - High Profile Surgical and Diagnostic Services
  • High Profile Surgical and Diagnostic Services Data Extras (2009)

8. Use of Personal Care Homes (PCHs) / Home Care Services

• Supply of PCH Beds (Provincial and Federal) - the average number of PCH beds per 1,000 residents 75 years and older.
• Admission to PCH - the percent of residents 75 years and older who were admitted to a PCH in a given year.
  
• Location: Where Residents went for Personal Care Home (PCH) Admissions*
  
• Residents in PCH - the percent of residents 75 years and older who lived in a PCH in a given year.
  
• Median Waiting Times for PCH Admission from Hospital (does not specify source of admission i.e. hospital or community)
  
• Median Waiting Times for PCH Admission from the Community
  
• Level of Care on Admission to PCH
  
• Median Length of Stay by Level of Care on Admission to PCH
  
  
• Home Care Services* (from the Manitoba RHA Indicators Atlas 2009)
  
  
  • Open Home Care Cases (Prevalence) - the percentage of the population (all ages) with an open home care case in a year.
    
  • New Home Care Cases (Incidence) - the percentage of the population (all ages) with a new home care case opened in a year.
    
  • Home Care Case Closings
    
  • Average Length of Home Care Cases - the average length (in days) of all home care cases open in a two-year period.

LINKS:
• The 2013 RHA Indicators Atlas (pdf) - Use of Personal Care Homes (PCHs)
  • Personal Care Homes Data Extras
• The Manitoba RHA Indicators Atlas 2009 (pdf) - Use of Personal Care Homes (PCHs)
  • Use of Personal Care Home Services Data Extras
• The Manitoba RHA Indicators Atlas 2009 (pdf) - Use of Home Care Services
  • Use of Home Care Services Data Extras

9. Immunizations and Prescription Drug Use / Other Preventative Services

• Influenza Immunization Among Adults 65 and Older
  
• Pneumococcal Immunization Among Adults 65 and Older
  
• Pharmaceutical Use - the percent of residents (all ages) who had at least one prescription dispensed in a given year.
  
• Number of Different Types of Drugs Dispensed per User - the average number of different types of drugs dispensed to each resident (all ages) who had at least one prescription in a given year.
  
• Antibiotic Prescriptions*
  
• Antidepressant Prescriptions*
  
• Opioid Prescriptions*
  
• Repeated Opioid Prescriptions*
  
• Opioid Defined Daily Doses (DDDs)*
  
• Benzodiazepine Prescriptions*
  
• Repeated Benzodiazepine Prescriptions*
  
• Benzodiazepine DDDs*
  
• Complete Immunization Schedule (Two-year olds)*
  
  
• Other Preventative Services* (from the Manitoba RHA Indicators Atlas 2009)
  
  
  • Mammograms
    
  • Cervical Cancer Screening - (Concept); Cervical Cancer Screening - (Glossary Definition)
    
  • Health Links/Info Santé Service

LINKS:
• The 2013 Health Indicators Atlas (pdf) - Immunization and Prescription Drug Use
  • Preventative and Other Services Data Extras
• The Manitoba RHA Indicators Atlas 2009 (pdf) - Preventive and Other Services
  • Preventive and Other Services Data Extras(2009)
• Profile of Metis Health Status and Healthcare Utilization in Manitoba: A Population-Based Study (pdf) - Prescription Use
  • Prescription Use Data Extras (Metis)

10. Quality of Primary Care

• Antidepressant Prescription Follow-Up
  
• Asthma Care: Controller Medication Use
  
• Diabetes Care: Eye Examinations
  
• Post-AMI Care: Beta-Blocker Prescribing
  
• Benzodiazepine Prescribing for Community-Dwelling Seniors (Older Adults)*
  
• Potentially Inappropriate Prescribing of Benzodiazepines to Older Adults (75+)*
  
• Benzodiazepine Prescribing for Residents of Personal Care Homes (PCH)

LINKS:
• The 2013 Health Indicators Atlas (pdf) - Quality of Primary Care
  • Quality of Primary Care Data Extras
• The Manitoba RHA Indicators Atlas 2009 (pdf) - Quality of Primary Care
  • Quality of Primary Care Data Extras (2009)