. 2022 Feb;67(2):117-129.

doi: 10.1177/07067437211043446. Epub 2021 Sep 27.

Measuring Substance-Related Disorders Using Canadian Administrative Health Databanks: Interprovincial Comparisons of Recorded Diagnostic Rates, Incidence Proportions and Mortality Rate Ratios

Christophe Huỳnh^{1

2

3

4

5}, Steve Kisely^{6

7}, Louis Rochette⁵, Éric Pelletier⁵, Kenneth B Morrison⁸, Shelley Li⁸, Gareth Hopkin^{9

10}, Mark Smith¹¹, Charles Burchill¹¹, Elizabeth Lin^{12

13

14}, Mark Asbridge⁶, Didier Jutras-Aswad^{1

2

15}, Alain Lesage^{1

2

5

16}

Affiliations

¹ University Institute on Addictions, 49987CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Québec.
² Department of Psychiatry and Addiction, University of Montréal, Montréal, Québec, Canada.
³ School of Psychoeducation, University of Montréal, Montréal, Québec, Canada.
⁴ Recherche et Intervention sur les Substances Psychoactives - Québec, Trois-Rivières, Québec, Canada.
⁵ 54470Institut National de Santé Publique du Québec, Québec, Canada.
⁶ Department of Community Health and Epidemiology, 12361Dalhousie University, Halifax, Nova Scotia, Canada.
⁷ School of Medicine, University of Queensland, Queensland, Australia.
⁸ 151965Alberta Health, Edmonton, Alberta, Canada.
⁹ Institute of Health Economics & University of Alberta, Edmonton, Alberta, Canada.
¹⁰ Health Technology Wales, 1029NHS Wales/GIG Cymru, Cardiff, Wales, UK.
¹¹ Manitoba Centre for Health Policy, Rady Faculty of Health Sciences, 50023University of Manitoba, Winnipeg, Manitoba, Canada.
¹² 7978Centre for Addiction & Mental Health, Toronto, Ontario, Canada.
¹³ Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
¹⁴ ICES, Toronto, Ontario, Canada.
¹⁵ Research Centre, 5622Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.
¹⁶ 25443Research Centre of the Montréal Mental Health University Institute, Montréal, Québec, Canada.

PMID: 34569874
PMCID: PMC8978214
DOI: 10.1177/07067437211043446

Measuring Substance-Related Disorders Using Canadian Administrative Health Databanks: Interprovincial Comparisons of Recorded Diagnostic Rates, Incidence Proportions and Mortality Rate Ratios

Christophe Huỳnh et al. Can J Psychiatry. 2022 Feb.

. 2022 Feb;67(2):117-129.

doi: 10.1177/07067437211043446. Epub 2021 Sep 27.

Authors

Affiliations

¹ University Institute on Addictions, 49987CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Québec.
² Department of Psychiatry and Addiction, University of Montréal, Montréal, Québec, Canada.
³ School of Psychoeducation, University of Montréal, Montréal, Québec, Canada.
⁴ Recherche et Intervention sur les Substances Psychoactives - Québec, Trois-Rivières, Québec, Canada.
⁵ 54470Institut National de Santé Publique du Québec, Québec, Canada.
⁶ Department of Community Health and Epidemiology, 12361Dalhousie University, Halifax, Nova Scotia, Canada.
⁷ School of Medicine, University of Queensland, Queensland, Australia.
⁸ 151965Alberta Health, Edmonton, Alberta, Canada.
⁹ Institute of Health Economics & University of Alberta, Edmonton, Alberta, Canada.
¹⁰ Health Technology Wales, 1029NHS Wales/GIG Cymru, Cardiff, Wales, UK.
¹¹ Manitoba Centre for Health Policy, Rady Faculty of Health Sciences, 50023University of Manitoba, Winnipeg, Manitoba, Canada.
¹² 7978Centre for Addiction & Mental Health, Toronto, Ontario, Canada.
¹³ Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
¹⁴ ICES, Toronto, Ontario, Canada.
¹⁵ Research Centre, 5622Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.
¹⁶ 25443Research Centre of the Montréal Mental Health University Institute, Montréal, Québec, Canada.

PMID: 34569874
PMCID: PMC8978214
DOI: 10.1177/07067437211043446

Abstract
in English, French

Context: Assessing temporal changes in the recorded diagnostic rates, incidence proportions, and health outcomes of substance-related disorders (SRD) can inform public health policymakers in reducing harms associated with alcohol and other drugs.

Objective: To report the annual and cumulative recorded diagnostic rates and incidence proportions of SRD, as well as mortality rate ratios (MRRs) by cause of death among this group in Canada, according to their province of residence.

Methods: Analyses were performed on linked administrative health databases (AHD; physician claims, hospitalizations, and vital statistics) in five Canadian provinces (Alberta, Manitoba, Ontario, Québec, and Nova Scotia). Canadians 12 years and older and registered for their provincial healthcare coverage were included. The International Classification of Diseases (ICD-9 or ICD-10 codes) was used for case identification of SRD from April 2001 to March 2018.

Results: During the study period, the annual recorded SRD diagnostic rates increased in Alberta (2001-2002: 8.0‰; 2017-2018: 12.8‰), Ontario (2001-2002: 11.5‰; 2017-2018: 14.4‰), and Nova Scotia (2001-2002: 6.4‰; 2017-2018: 12.7‰), but remained stable in Manitoba (2001-2002: 5.5‰; 2017-2018: 5.4‰) and Québec (2001-2002 and 2017-2018: 7.5‰). Cumulative recorded SRD diagnostic rates increased steadily for all provinces. Recorded incidence proportions increased significantly in Alberta (2001-2002: 4.5‰; 2017-2018: 5.0‰) and Nova Scotia (2001-2002: 3.3‰; 2017-2018: 3.8‰), but significantly decreased in Ontario (2001-2002: 6.2‰; 2017-2018: 4.7‰), Québec (2001-2002: 4.1‰; 2017-2018: 3.2‰) and Manitoba (2001-2002: 2.7‰; 2017-2018: 2.0‰). For almost all causes of death, a higher MRR was found among individuals with recorded SRD than in the general population. The causes of death in 2015-2016 with the highest MRR for SRD individuals were SRD, suicide, and non-suicide trauma in Alberta, Ontario, Manitoba, and Québec.

Discussion: Linked AHD covering almost the entire population can be useful to monitor the medical service trends of SRD and, therefore, guide health services planning in Canadian provinces.

Contexte: Évaluer les changements temporels des taux diagnostiques enregistrés, les proportions de l’incidence et les résultats de santé des troubles liés aux substances (TLS) peut informer les décideurs de la santé publique dans la réduction des méfaits associés à l’alcool et autres drogues.

Objectif: Faire rapport sur les taux diagnostiques enregistrés annuels et cumulatifs et les proportions de l’incidence des TLS, ainsi que les rapports des taux de mortalité (RTM) par cause de décès au sein de ce groupe au Canada, selon leur province de résidence.

Méthodes: Des analyses ont été exécutées sur des bases de données de santé administratives couplées (réclamations de médecins, hospitalisations, statistiques vitales) dans cinq provinces canadiennes (Alberta, Manitoba, Ontario, Québec, et Nouvelle-Écosse). Des Canadiens de 12 ans et plus inscrits à leur assurance-santé provinciale étaient inclus. La Classification internationale des maladies (CIM-9 ou −10 codes) a servi à l’identification de cas de TLS d’avril 2001 à mars 2018.

Résultats: Durant la période de l’étude, les taux diagnostiques de TLS enregistrés annuellement ont augmenté en Alberta (2001–2002 : 8,0 ‰; 2017–2018 : 12,8 ‰), en Ontario (2001–2002 : 11,5 ‰; 2017–2018 : 14,4 ‰), et en Nouvelle-Écosse (2001–2002 : 6,4 ‰; 2017–2018: 12,7 ‰), mais sont demeurés stables au Manitoba (2001–2002 : 5,5 ‰; 2017–2018 : 5,4 ‰) et au Québec (2001–2002 et 2017–2018 : 7,5 ‰). Les taux diagnostiques de TLS cumulatifs enregistrés ont augmenté régulièrement pour toutes les provinces. Les proportions de l’incidence enregistrées se sont accrues significativement en Alberta (2001–2002 : 4,5 ‰; 2017–2018 : 5,0 ‰) et en Nouvelle-Écosse (2001–2002 : 3,3 ‰; 2017–2018 : 3,8 ‰), mais ont significativement diminué en Ontario (2001–2002 : 6,2 ‰; 2017–2018 : 4,7 ‰), au Québec (2001–2002 : 4,1 ‰; 2017–2018 : 3,2 ‰) et au Manitoba (2001–2002 : 2,7 ‰; 2017–2018 : 2,0 ‰). Pour presque toutes les causes de décès, des RTM plus élevés ont été constatés chez les personnes ayant des TLS enregistrés que dans la population générale. Les causes de décès en 2015–2016 avec les RTM les plus élevés pour les personnes présentant de TLS étaient les TLS, le suicide, et les traumatismes de non-suicide en Alerta, en Ontario, au Manitoba, et au Québec.

Discussion: Les bases de données de santé administratives jumelées qui couvrent presque la population en entier peuvent être utiles pour surveiller les tendances des services médicaux de TLS et par conséquent, guider la planification des services de santé dans les provinces canadiennes.

Keywords: Canada; alcohol-related disorders; healthcare administrative claims; international classification of diseases; premature mortality; substance-related disorders.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

**Figure 1.**
Age-standardized cumulative recorded diagnostic rates of substance-related disorders (SRD) by province, 2001-2002 to 2017-2018. (A) SRD. (B1) Alcohol-related disorders. (B2) Alcohol use disorders only. (C1) Drug-related disorders. (C2) Drug use disorders only.

**Figure 2.**
Age-standardized incidence recorded proportions of substance-related disorders (SRD) by province, 2001-2002 to 2017-2018. (A) SRD. (B1) Alcohol-related disorders. (B2) Alcohol use disorders. (C1) Drug-related disorders. (C2) Drug use disorders.

**Figure 3.**
Annual mortality rates among cumulative cases. (A) Substance-related disorders. (B1) Alcohol-related disorders. (B2) Alcohol use disorders. (C1) Drug-related disorders. (C2) Drug use disorders.

See this image and copyright information in PMC

References

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1. Kisely S, Lin E, Lesage A, et al. Use of administrative data for the surveillance of mental disorders in 5 provinces. Can J Psychiatry Rev Can Psychiatr. 2009;54(8):571‐575. doi: 10.1177/070674370905400810 - DOI - PubMed
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Measuring Substance-Related Disorders Using Canadian Administrative Health Databanks: Interprovincial Comparisons of Recorded Diagnostic Rates, Incidence Proportions and Mortality Rate Ratios

Affiliations

Measuring Substance-Related Disorders Using Canadian Administrative Health Databanks: Interprovincial Comparisons of Recorded Diagnostic Rates, Incidence Proportions and Mortality Rate Ratios

Authors

Affiliations

Abstract
in English, French

Conflict of interest statement

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous

Abstract in English, French

Conflict of interest statement

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous

Abstract
in English, French