CIHI releases new length-of-stay data
OTTAWA – After declining every year between 1995–1996 and 2002–2003,
Canada’s acute care hospitals experienced slight increases in
hospitalizations in both 2003–2004 and 2004–2005.
That’s according to new data from the Canadian Institute for Health
Furthermore, while the average length of stay in hospital has been on
the rise over the past decade, in 2003–2004, it decreased from 7.0 days
to 6.9 days and then remained the same in 2004–2005.
Inpatient hospitalizations and average lengths of stay continue to vary
The increase in the total number of inpatient hospitalizations in
2004–2005 (up by 0.8% to 2,161,848) was primarily due to increases in
three provinces: Ontario (up 20,980), British Columbia (up 3,716) and
Alberta (up 3,140). The Yukon Territory also saw an increase, with an
additional 250 hospitalizations.
The remaining provinces and territories (excluding Quebec) all had
declining inpatient hospitalizations. New Brunswick reported a decrease
of 5,036, while Newfoundland and Labrador had 2,101 fewer
hospitalizations, Saskatchewan had 1,617 fewer, and Nunavut saw a
decrease of 51. Quebec had an increase of 17,178 inpatient
hospitalizations in 2003–2004, the most recent year for which data were
available to CIHI.
On a per capita basis, there were 8.4 hospitalizations for every 100
Canadians in 2004–2005. There continues to be considerable variation
among provincial and territorial hospitalization rates in comparison to
the national average. Some provinces, such as Prince Edward Island and
Saskatchewan, were well above the national average (almost 12
hospitalizations per 100 residents), while other provinces, such as
Manitoba and Alberta, were only slightly above the average (about 9.4
hospitalizations per 100 residents). Only Ontario and British Columbia
were below the average (about 7.7 hospitalizations per 100 residents).
All of the territories continue to have hospitalization rates over the
For three provinces -— Saskatchewan, Alberta and British Columbia —-
there was no change in average number of days patients stayed in
hospital, which was the case for Canada as a whole.
The Northwest Territories, Manitoba, Nova Scotia and Newfoundland and
Labrador all saw increases in average lengths of stay, while the
remaining provinces and territories experienced decreases. Quebec saw a
decrease of 1.1% in average number of days spent in hospital in
Acute inpatient hospitalizations and average lengths of stay vary across
the country for a number of reasons, including differences in health
status, in the way in which healthcare systems are structured and in the
criteria used to determine hospital admission.
Overall changes in hospitalizations and lengths of stay in Canada over
the past 10 years indicate shifts in types of patients being
Over the past decade, while inpatient hospitalizations declined by 13%,
the average number of days spent in hospital increased by 3%.
In 1995–1996, acute care hospitals handled 2.5 million hospitalizations,
and the average length of stay was 6.7 days. Ten years later,
hospitalizations were down to 2.2 million in 2004–2005, but the average
length of stay was up to 6.9 days.
The fact that the number of Canadians being hospitalized decreased over
the last 10 years, while the average number of days spent in hospital
increased, is reflective of a shift in the types of patients being
hospitalized and how they are being treated.
“Patients who would have been hospitalized 10 years ago for treatment of
a particular condition, such as tonsillitis, are now receiving
ambulatory care instead, such as same day surgery,” says Nizar Ladak,
CIHI’s Director of Health Services Information.
Most of Canada’s inpatient hospitalizations are not for patients having
According to CIHI’s data, most admissions to Canada’s acute care
hospitals in 2004–2005 were for medical treatments other than surgery.
Only a little over a quarter (27%) of Canada’s inpatient
hospitalizations were for patients having surgery, while the largest
proportion (41%) was categorized as “medical” patients. These are adult
patients who are most frequently treated for such conditions as
digestive diseases, respiratory diseases (for example, pneumonia and
bronchitis), heart diseases and diabetes. The remaining hospitalizations
were for maternal care (13%), newborns (11%), pediatrics (5%) and mental
In addition to accounting for the most hospitalizations in Canada,
medical patients also stayed longer in hospital (8.9 days) than any of
the other patient groups, except for mental health (14.0 days). Surgical
patients had the third-longest average length of stay (5.4 days),
followed by pediatric patients (5.1 days). Maternal care and newborn
patients spent the least amount of time in hospital (2.6 days and 3.0
The majority of Canadians who are hospitalized start off in emergency
In 2004–2005, over half (53%) of all Canadians who were hospitalized
were admitted via an emergency department. These patients stayed, on
average, nearly three days longer (8.0 days compared to 5.1 days) than
patients admitted by other means, such as planned admissions, direct
admissions from a doctor’s office or clinic, or transfers from another
facility. Medical patients were the most likely patient group to be
admitted from an emergency department, with over three-quarters (77%)
starting off in an emergency department. In comparison, the majority
(66%) of surgical patients were admitted by other means.
More than 10% of hospitalized Canadians spend time in special care
In 2004–2005, slightly more than 1 out of 10 (11%) patients hospitalized
in Canada spent time in a special care unit (“special care unit” refers
to all specially equipped inpatient units in which constant supervision
and monitoring are provided to seriously ill patients). Burn care units,
neonatal care units and cardiac care units are examples of special care
units found in Canada’s acute care facilities. The average number of
days in hospital for these patients (14.5 days) was more than twice that
for other patients (5.9 days). About 1 out of 7 (14%) medical patients
were in need of special care unit services, more than any other patient
group. The 1 out of 10 surgical patients who needed special care
services were found to stay in hospital longer than all other patients,
at 20.3 days on average.
About inpatient hospitalizations
The data in this release are derived from an “Analysis in Brief” that
presents the latest available data from CIHI’s national Hospital
Morbidity Database and Discharge Abstract Database. Data from Quebec for
fiscal year 2004–2005 were not available to CIHI at the time of the data
release.For the purposes of this release, “inpatient hospitalization”
refers to the entirety of an event in which a person is admitted to an
acute care hospital as an inpatient, stays in hospital and is discharged
(via release or death). Inpatient hospitalization rates are important
measures of illness in the population and utilization of inpatient
hospital services over time. The inpatient hospitalization statistics
reflect the number of hospitalizations, which is somewhat higher than
the number of individuals hospitalized, since individuals with multiple
admissions during a single year would be counted more than once in the
discharge totals. Inpatient hospitalization data refer to acute
inpatient events only and exclude patients treated in other types of
care facilities, such as emergency departments, chronic care and
rehabilitation units and day surgery programs.
The Canadian Institute for Health Information (CIHI) collects and
analyzes information on health and health care in Canada and makes it
publicly available. Canada’s federal, provincial and territorial
governments created CIHI as a not-for-profit, independent organization
dedicated to forging a common approach to Canadian health information.
CIHI’s goal: to provide timely, accurate and comparable information.
CIHI’s data and reports inform health policies, support the effective
delivery of health services and raise awareness among Canadians of the
factors that contribute to good health.