"Identifying Information: Name","Death at Home or in Community"
"Identifying Information: Short/Other Names","Percentage of People Who Die Outside of Hospitals Each Year"
"Identifying Information: Description","Percentage of Canadians who die at home or in the community each year“Home or community” is broadly defined as a location that a person resides in at the end of life, excluding hospitals and other acute care facilities. Locations includeLong-term care facilitiesHospices Nursing homes Residential homes Assisted-living facilitiesGroup care homes This definition is intended to include the many types of living situations that may be considered “home” at the end of life. "
"Background, Interpretation and Benchmarks: Rationale","Measuring the percentage of Canadians who die at home or in the community, rather than in hospital, provides an indication of whether Canadians are getting access to community-based end-of-life care services. Many Canadians would prefer to receive end-of-life care at home rather than in hospital. One of the main barriers to dying at home is lack of support in the home. If more services in the home were available, more people could potentially be supported in dying at home. This indicator can monitor progress being made toward improving access to community-based end-of-life care services. "
"Background, Interpretation and Benchmarks: Interpretation","A higher percentage is desirable."
"Background, Interpretation and Benchmarks: HSP Framework Dimension","Access to comprehensive, high-quality health services"
"Background, Interpretation and Benchmarks: Areas of Need","End of Life"
"Background, Interpretation and Benchmarks: Targets/Benchmarks",N/A
"Available Data Years","2020
 to 2022"
"Available Data Years: Type of Year",Calendar
"Availability of Results: Geographic Coverage","All provinces/territories"
"Reporting Level/Disaggregation",National
"Result Updates: Indicator Results","Web Tool:Your ������ϱ� System: In Brief - Death at Home or in Community"
"Update Frequency","Every year"
"Result Updates: Latest Results Update Date","December 2024"
"Result Updates: Updates",N/A
"Indicator Calculation: Description","The percentage of people who die outside the hospital each yearThe numerator is the total number of deaths at home or in the community. This is calculated based on the difference between the total number of deaths in Canada and the total number of deaths in emergency departments and acute care hospitals. The denominator is the total number of deaths in Canada. (All deaths in Canada [CVSD and Yukon death data] – Deaths in acute care hospitals and EDs [DAD/HMDB, OHMRS, NACRS]) ÷ All deaths in Canada (CVSD and Yukon death data)NotesCVSD: Canadian Vital Statistics Death Database.ED: Emergency department.DAD/HMDB: Discharge Abstract Database/Hospital Morbidity Database OMHRS: Ontario Mental ������ϱ� Reporting System.NACRS: National Ambulatory Care Reporting System."
"Indicator Calculation: Type of Measurement","Percentage or proportion"
"Denominator: Description:","All deaths that occur in the calendar year (captured in CVSD and Yukon death data)"
"Denominator: Inclusions:","All deaths in Canada in a calendar year: CVSD data Yukon death data "
"Denominator: Exclusions:","CVSD: Deaths from external causes: Land transport accidents (V01–V89)Assaults (X85–Y09, Y87.1)Self-harm (X60–X84, Y87.0) Poisonings (X40–X49, X60–X69, Y10–Y19)Yukon: Category codes for assaults and self-harm"
"Numerator: Description:","All deaths in the community in Canada in a calendar year•    Calculated by subtracting hospital and ED deaths from all deaths (CVSD/Yukon)"
"Numerator: Inclusions:","Deaths captured in acute and psychiatric hospitals (DAD/HMDB/OMHRS) All deaths captured in NACRS, CVSD data and Yukon death data Emergency department records (Amcare_Group_Code = ED)Sex coded as male or female (Sex = M, F)Records with valid age  "
"Numerator: Exclusions:","Deaths from external causes:Land transport accidents  (V01–V89)Assaults (X85–Y09, Y87.1) Self-harm (X60–X84, Y87.0)Suicide in facility (visit disposition = 74 in NACRS; discharge reason code = 2 in OMHRS)Poisonings (X40–X49, X60–X69, Y10–Y19)Dead on arrival (visit disposition = 71 in NACRS)Stillbirths and cadaveric donors"
"Method of Adjustment","Direct standardization"
"Adjustment Applied",Age-adjusted
"Indicator Calculation: Geographic Assignment","Place of residence"
"Data Sources: Other Data Source","DAD/HMDBNACRSOMHRSVital Statistics - Death Database, Statistics CanadaVital Statistics Death Database, Yukon Government "
"Quality Statement: Caveats and Limitations","Results are based on all available data reported to CIHI; data coverage differs across jurisdictions. Therefore, results should not be compared.Some hospitals may have palliative care units that provide care similar to that offered community hospices, but these cannot be differentiated in the data. This may result in a higher number of in-hospital deaths for jurisdictions that have more dedicated inpatient palliative care.Certain patients may prefer hospital-based care at the end of life. As well, in some regions (e.g., rural and remote areas of Canada), acute care hospitals may be the only care setting in which patients can access palliative or end-of-life care services.Yukon Vital Statistics data is not currently submitted to the CVSD; therefore, categories in the Yukon Vital Statistics may be associated with errors. Additionally, death data may be incomplete. This indicator should be interpreted with caution for the Yukon.Due to coding practices of capturing deaths occurring in the community in Quebec emergency department data systems, we strongly suggest that information on deaths be used with caution."
"Quality Statement: Trending Issues",N/A
"Quality Statement: Comments","Pooled death data from 2017 to 2019 is used to age-standardize results.This indicator belongs to the Shared ������ϱ� Priorities portfolio measuring access to mental health and substance use services and to home and community care. More information on this indicator is available in the 2022 companion report (PDF).  "
References,"Canadian Institute for ������ϱ� Information. Access to Palliative Care in Canada. 2018."