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2014 Canadian Population Health Association Conference Toronto, Canada

Socio-economic gradients in the occurrence of stroke and 30 days in-hospital mortality after a stroke in Canada. 2014 Canadian Population Health Association Conference Toronto, Canada. Z. Chaudhary, K. Nguyen, L. Yin, C. Tosevski, Y. Gurevich Canadian Institute for Health Information.

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2014 Canadian Population Health Association Conference Toronto, Canada

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  1. Socio-economic gradients in the occurrence of stroke and 30 days in-hospital mortality after a stroke in Canada 2014 Canadian Population Health Association Conference Toronto, Canada Z. Chaudhary, K. Nguyen, L. Yin, C. Tosevski, Y. Gurevich Canadian Institute for Health Information

  2. Overview • Introduction • Why Stroke? • Indicators (Stroke Event and 30-Day Stroke In-hospital Mortality) • SES lens • Results • Concluding remarks • Resources

  3. Why Stroke?

  4. Stroke Indicators • Stroke Event Rate Age-standardized rate of new stroke events admitted to an acute care hospital, per 100,000 population age 20 and older • 30-Day Stroke In-Hospital Mortality The risk-adjusted rate of all-cause in-hospital deaths occurring within 30 days of first admission to an acute care hospital with a diagnosis of stroke

  5. General Methodology Data Source - Discharge Abstract Database (DAD) • Acute care hospitalization data from all provinces/territories except Quebec • Rates for Quebec are not available due to differences in data collection Level of Reporting - based on patient postal code of residence • Canada • Provinces/territories • Regions

  6. SES Lens • Social stratification and income distribution have an impact on population health and safety • Measuring and reporting health disparities are important because some of them may be reduced or prevented • Understanding Stroke in the socio-economic context could help to focus on areas where interventions are more needed

  7. SES Lens (cont’d) • Neighbourhood Income Quintile - used as a proxy for SES (Quintile 1 – least affluent, Quintile 5 - most affluent) • Disparity Rate Ratio Ratio of the rate of a health indicator for the least affluent neighbourhoodincome quintile to the rate for the most affluent neighbourhoodincome quintile • Potential Rate Reduction Potential reduction in a health indicator rate that would occur in the hypothetical scenario that each socio-economic group in the jurisdiction experienced the rate of the most affluent socio- economic group

  8. Hospitalized Stroke Events Rate - National Trend ↓ 9% ↓ 9% ↓ 11% *Age-Standardized Rates exclude Quebec

  9. Hospitalized Stroke Event Rate - Provincial Variation FY2007-2008 & FY2012-2013 130 118

  10. Stroke Event Rate - by SES FY 2007-2008 & FY 2012-2013

  11. Stroke Event Rate - by SES and GenderFY 2012-2013

  12. Hospitalized Stroke Rates - by SES & ProvinceFY 2012-2013 PRR-11% ↓

  13. 30-Day Stroke In-hospital Mortality National Trend

  14. 30-day In-hospital Stroke Mortality Provincial Variation, 2009 & 2011

  15. 30-day In-hospital Stroke Mortality - by SES2009 & 2011

  16. Concluding Remarks • Hospitalizations for stroke present a consistent association with socio-economic status. • However once the patients are admitted to hospital difference in stroke mortality rates by socio-economic status are much less • Examining trends and variations could help jurisdictions identify areas for improvement • Could be used to target efforts needed to close sex and socio-economic gaps

  17. Resources • OurHealthSystem.ca website • Indicator results at national, provincial/territorial and health region level www.OurHealthSystem.ca • Health Indicators e-publication • Indicator results at national, provincial /territorial and health region level www.cihi.ca/hirpt • Indicator Library • http://indicatorlibrary.cihi.ca

  18. Questions? Zeerak Chaudhary Project Lead, Health Indicators & Client Support, Canadian Institute for Health Information (CIHI) Email: zchaudhary@cihi.ca

  19. Thank You!

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