Christophe Huỳnh1,2,3,4,5, Steve Kisely6,7, Louis Rochette5, Éric Pelletier5, Kenneth B Morrison8, Shelley Li8, Gareth Hopkin9,10, Mark Smith11, Charles Burchill11, Elizabeth Lin12,13,14, Mark Asbridge6, Didier Jutras-Aswad1,2,15, Alain Lesage1,2,5,16. 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.
Abstract
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.
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.
Entities:
Keywords:
Canada; alcohol-related disorders; healthcare administrative claims; international classification of diseases; premature mortality; substance-related disorders
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