Snapshot: Health inequities in alcohol-attributable hospitalizations 17/01/2020 TECHNICAL NOTES Health Inequities in Alcohol-Attributable Hospitalizations About This Health Equity Snapshot summarizes how rates of alcohol-attributable hospitalizations vary across levels, or quintiles, of marginalization for the province, Local Health Integration Networks (LHINs), and public health units (PHUs). Data are reported by 2 year intervals for the years 2004-2005 to 2016-2017. This Snapshot reports on seven summary measures of socioeconomic inequality which quantify the differences between quintile-specific rates of health status. The summary measures included are: Rate Ratio Rate Difference Relative Index of Inequality (ratio) Relative Index of Inequality (mean) Slope Index of Inequality Population Attributable Fraction Population Impact Number These seven summary measures are calculated for the four dimensions of the Ontario Marginalization Index (ON-Marg). Provincial and local-level ON-Marg quintile cutoffs are available for: Material Deprivation Residential Instability Dependency Ethnic Concentration For more information on these dimensions, including how they were created and defined, please see our FAQs. Data sources, indicator definitions, and health equity analysis methodology are described below.
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Snapshot: Health inequities in alcohol-attributable hospitalizations 17/01/2020
TECHNICAL NOTES
Health Inequities in Alcohol-Attributable Hospitalizations
About This Health Equity Snapshot summarizes how rates of alcohol-attributable hospitalizations vary across
levels, or quintiles, of marginalization for the province, Local Health Integration Networks (LHINs), and
public health units (PHUs). Data are reported by 2 year intervals for the years 2004-2005 to 2016-2017.
This Snapshot reports on seven summary measures of socioeconomic inequality which quantify the
differences between quintile-specific rates of health status. The summary measures included are:
Rate Ratio
Rate Difference
Relative Index of Inequality (ratio)
Relative Index of Inequality (mean)
Slope Index of Inequality
Population Attributable Fraction
Population Impact Number
These seven summary measures are calculated for the four dimensions of the Ontario Marginalization
Index (ON-Marg). Provincial and local-level ON-Marg quintile cutoffs are available for:
Material Deprivation
Residential Instability
Dependency
Ethnic Concentration
For more information on these dimensions, including how they were created and defined, please see our FAQs. Data sources, indicator definitions, and health equity analysis methodology are described below.
Snapshot: Health inequities in alcohol-attributable hospitalizations 17/01/2020
Indicator Definition: Alcohol-Attributable Hospitalizations Description: Age standardized rate (per 100,000) of hospitalizations for conditions that are entirely
attributable to alcohol use. This indicator definition was adapted from:
Canadian Institute for Health Information. Indicator library. Hospitalizations entirely caused by
alcohol [Internet]. Ottawa, ON: Canadian Institute for Health Information; 2018 [cited 2019 Mar
25]. Available from: http://indicatorlibrary.cihi.ca/pages/viewpage.action?pageId=10453006
Numerator: Number of individuals who have been hospitalized with a condition considered to be 100%
attributable to alcohol and captured in the Discharge Abstract Database (DAD) or the Ontario Mental
Health Reporting System (OMHRS) (as of April 1, 2006). Includes only those in acute care facilities, and
designated acute adult mental health beds. Records from OMHRS include DSM-IV and DSM-5 codes as
primary or secondary diagnoses (DSM-IV Axis I Primary, DSM-IV Axis I Sec Dx, DSM-IV Axis I Tert Dx,
DSM-IV Axis I Quat Dx, DSM-IV Axis II Other Primary Dx, DSM-IV Axis II Other Sec Dx, DSM-5 Psychiatric
Dx A, DSM-5 Psychiatric Dx B, DSM-5 Psychiatric Dx C, DSM-5 Psychiatric Dx D, DSM-5 Psychiatric Dx E,
DSM-5 Psychiatric Dx F). See section below for ICD-10, DSM-IV and DSM-5 codes.
Denominator: Census population.
Exclusions: Records with invalid or missing postal codes Non-Ontario residents Cases geocoded to DAs that are not assigned ON-Marg quintile values
ICD-10, DSM-IV, and DSM-5 Condition Codes:
Table 1. ICD-10 codes for conditions that are definitely attributable to alcohol use for use
with Discharge Abstract Database (DAD)
Condition ICD-10 Code
Alcohol-induced Pseudo-Cushing’s Syndrome E24.4
Mental and Behavioural Disorders Due to Use of Alcohol F10
Degeneration of Nervous System Due to Alcohol G31.2
Methodology The analytic approach taken to calculate the results presented in this snapshot is as follows:
1. Assign cases to a level of marginalization
2. Calculate age-standardized quintile-specific rates of health status
3. Calculate summary measures of socioeconomic inequality
1) Assign cases to a level of marginalization Individuals who appear in administrative health data are assigned to a level of marginalization using the
Ontario Marginalization Index (ON-Marg). ON-Marg is an area-based deprivation index that uses factor
analysis of 18 indicators of socioeconomic status to provide measurement of four dimensions of