4.0 Community and health system characteristics

4.1 Population (1996 and 1997)

Sources: Statistics Canada, Demography Division. Data are derived from the Census and administrative sources on births, deaths, and migration. Population data for Quebec and British Columbia were supplied by the Institut de la statistique du Qu�bec and BC Stats respectively.

4.2 Population 65 years and over

Definition: The proportion of people aged 65 years and over living in a geographic area, by sex.

Canadians aged 65 and over are specifically noted, because of their growing proportion of the population and their greater health care needs.

Sources: Statistics Canada, Demography Division. Data are derived from the Census and administrative sources on births, deaths, and migration. Population data for Quebec and British Columbia were supplied by the Institut de la statistique du Qu�bec and BC Stats respectively.

4.3 Urban population

Definition: The proportion of population in a geographic area living in urban areas having minimum population of 1,000 and a population density of 400 people per square kilometre.

This community characteristic allows users to compare regions with similar proportions of urban/rural population.

Source: Statistics Canada, derived from 1996 Census

4.4 Aboriginal population

Definition: The proportion of Aboriginal people in a geographic area.

Health status characteristics and non-medical determinants of Aboriginal people differ from the non-Aboriginal population, for example, infant mortality, unintentional injury deaths, suicides and smoking rates. Knowing the proportion of Aboriginal people in a geographic area provides context to better interpret health indicators.

Sources: Statistics Canada, 1996 Census, 1996 Census Coverage Studies, and Demography Division (population estimates)

4.5 Immigrant population

Definition: The proportion of immigrants in a geographic area, and the proportion of those immigrants who came to Canada from 1981 to 1996.

Canadian, American and Australian studies have shown that immigrants, particularly non-European immigrants, generally have a longer life expectancy and lower risk of certain chronic conditions than the native-born population. However, the Canadian studies have also shown that as the immigrants' period of residence in Canada increases, so does the prevalence of chronic conditions, smoking and disability. Understanding the proportion of immigrants in a geographic area, along with the period of immigration, provides a context for interpreting health indicators.

Source: Statistics Canada, 1996 Census

4.7 Doctors

Definition: Active civilian general practitioners or family practitioners per 100,000 population on December 31st of the reference year; active civilian medical specialists per 100,000 population on December 31st of the reference year.

Physician to population ratios are used to support health human resource planning. Physician density ratios do not take into account workload or type of services provided. In some regions, health facilities and personnel provide services to a larger community than the residents of the immediate region. In others, residents may seek care from physicians and Specialists outside the region where they live. The ratio of physicians to population reflects the number of doctors in a region and has not been adjusted to take these movements into account. The extent to which this affects individual regions is likely to vary.

Source: Canadian Institute for Health Information, Southam Medical Database

4.9 Coronary artery bypass grafts (CABG)

Definition: Age-standardized rate of coronary artery bypass graft (CABG) surgery performed on inpatients in acute care hospitals per 100,000 population age 20 and over.

(CCP code 48.1 or ICD-9-CM procedure code 36.1).

As with other types of procedures, variations in CABG surgery rates can be attributed to numerous factors, including differences in population demographics, physician practice paterns, availability of services, and prevalence of cardiovascular disease. In Ontario, the provincial benchmark for CABG surgery is 100 per 100,000 population (Cardiovascular Health and Services in Ontario. ICES, 1999).

Source: Canadian Institute for Health Information, Hospital Morbidity Database

4.10 Hip replacement

Definition: Age-standardized rate of total hip replacement surgery (unilateral orbilateral) performed on inpatients in acute care hospitals per 100,000 population.

(CCP code of 93.51 or 93.59 or ICD-9-CM procedure code of 81.51or 81.53).

Hip replacement surgery has the potential to result in considerable improvement in functional status, pain relief, as well as other gains in health-related quality of life. Over the past two decades, rates of surgery have increased substantially. Wide inter-regional variation in the hip replacement rate may be attributable to numerous factors including the availability of services, provider practice patterns, and patient preferences.

Source: Canadian Institute for Health Information, Hospital Morbidity Database

4.11 Knee replacement

Definition: Age-standardized rate of total knee replacement surgery (unilateral orbilateral) performed on inpatients in acute care hospitals per 100,000 population.

(CCP code of 93.41 or ICD-9-CM procedure code of 81.54 or 81.55).

Knee replacement surgery has the potential to result in considerable improvement in functional status, pain relief, as well as other gains in health-related quality of life. Over the past two decades, rates of surgery have increased substantially. Wide inter-regional variation in the knee replacement rate may be attributable to numerous factors including the availability of services, provider practice patterns, and patient preferences.

Source: Canadian Institute for Health Information, Hospital Morbidity Database

4.12 Hysterectomy

Definition: Age-standardized rate for hysterectomies provided to inpatients in acute care hospitals, per 100,000 women age 20 and older.

(CCP code of 80.2-80.7 or ICD-9-CM procedure code of 68.3-68.9).

Utilization rates may reflect the level of uncertainty about the appropriate use of this surgical procedure. The "right" level of utilization is not known. In Canada, inter-regional hysterectomy rates vary two to three-fold.

Source: Canadian Institute for Health Information, Hospital Morbidity Database