Hospitalization rates and length of stay for cardiovascular conditions in Canada, 1994 to 1999

Background — Cardiovascular diseases (CVDs) are a leading cause of hospitalization in Canada. An examination of recent trends in cardiovascular hospitalization rates across Canada is of considerable value and interest to health policy decision makers and administrators, clinicians and researchers.

Objectives — To examine temporal trends and regional variation in hospitalization rates and length of stay for CVD conditions in Canada.

Methods — Hospital discharge data for fiscal years 1994/95 to 1999/2000 were used to identify all Canadians who were hospitalized with the most responsible diagnoses of acute myocardial infarction (AMI), congestive heart failure (CHF), angina and chest pain. Direct age- and sex-standardized hospitalization rates were calculated by province and health region. Length of stay (LOS) for episodes of hospital care were adjusted for age, sex and cardiac procedures using ordinary least squares regression.

Results — Overall, AMI, angina and chest pain hospitalization rates increased 6%, 8% and 11%, respectively, between fiscal years 1994/95 and 1999/2000 and decreased by 7% for CHF in Canada. There was wide regional variation in cardiovascular hospitalization rates in Canada, with the greatest variation seen in CHF, chest pain and angina, and the least seen in AMI. There was a modest downward trend in adjusted LOS between fiscal years 1994/95 and 1999/2000. In general, patients hospitalized in provinces in western Canada and Ontario had shorter LOS for all conditions when compared with those in Quebec and the eastern provinces.

Conclusions — AMI, angina and chest pain hospitalization rates in Canada increased between fiscal years 1994/95 and 1999/2000, while CHF rates declined. There is considerable regional variation in the cardiovascular hospitalization rates across the country that may be amenable to further interventional strategies.