Discharge Abstract Database (DAD)
Product Review
Alexandra Cooper
Queen’s University
DLI Ontario Training, November 2016
Background
Originally developed in 1963, the Discharge Abstract Database (DAD) captures
administrative, clinical and demographic information on hospital discharges
(including deaths, sign-outs and transfers). Some provinces and territories also
use the DAD to capture day surgery.
Background
Data availability:
• Most recent full year – 2015-2016
• Historical series – 1994-1995 to 2014-2015
Access to full database from CIHI
• Data request form
• Graduate Student Data Access Program
DAD data is also used to populate other CIHI databases, including:
• The Hospital Morbidity Database (HMDB)
• The Hospital Mental Health Database (HMHDB)
Data Source
Data is received directly from
• acute care facilities or
• their respective health/regional authority or
• ministry/department of health
Facilities in all provinces and territories except Quebec are required to report.
Data from Quebec is submitted to CIHI directly by the ministère de la Santé et
des Services sociaux du Québec.
Data elements
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Abstract Identification
Length of Stay
Patient Demographics
Admission Data
Discharge Data
Patient Service Information
Service Transfers
Not all in DLI sample files
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Provider Information
Diagnosis Information
Intervention Information
Special Care Information
Blood Information
Reproductive Care Information
DLI DAD Sample Files
• 10% sampling of persons from the database
• Acute inpatient cases form all provinces/territories except Quebec and British
Columbia
• Reference dates are randomly assigned to selected individuals
• 2 files received from CIHI - Clinical and Geographic
• Enhanced Clinical and Geographic Files – created by Vince Grey, Western
University
DLI DAD Sample Files
Fiscal years
• 2009-2010 to 2010-2011
• 2011-2012 to 2012-2013
• 2013-2014
• 2014-2015
Geography
• Province and Territory (grouped)
• Health Region
Excluded
• Stillbirths (ENT_CODE = S)
• Cadaveric donations (ADM_CAT = R)
• All therapeutic abortion (TA) records
DLI DAD Sample Files
Access
CIHI DAD Sample files are included in the DLI License as an appendix
Download from the DLI EFT
• MAD_CIHI_ICIS_DAM folder (including the Vince’s Enhanced
files)
Download from <odesi>
• Before accessing files user must accept the license agreement
DLI DAD Sample Files
Clinical Data File
• Clinical details:
• Diagnoses (1-25): code (ICD-10-CA) and type
• Interventions (1-20): code (CCI), status, location, anaesthetic
technique
• Special care unit visits (1-6): type/number and hours
• Length of stay: seven categories (0, 1, 2, 3, 4-5, 6-9, 10+ days)
• Newborn weights: six categories (under 750, 750-999, 1000-1499, 15001999, 2000-2499, 2500+ grams)
• Gestation weeks at delivery: four categories (under 32, 32-33, 34-36, 37+
weeks)
DLI DAD Sample Files
Geographic Data File
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Health Region
Case Mix variables:
• Major Clinical Category (MCC)
• Case Mix Group (CMG)
• CMG age category
• Resource Intensity Weight (RIW)
• Expected Length Of Stay (ELOS)
• RIW Atypical code
• Resource Intensity Level
• Length of Stay: three categories (0, 1-2, 3+ days)
DLI DAD Sample Files
Common Data Elements
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Person identifier – meaningless except to identify discharge records for same
person within file
Facility province or territories (grouped)
Discharge day – relative to reference day
Admission day – relative to reference day; calculated using collapsed total
length of stay
Gender (male or female only)
Age group
DLI DAD Sample Files
Enhanced Data File
File created by Vince Grey, Western University, to address issue with
ICD-10* and CCI* variables in CIHI files
Documentation and Readme about Enhanced files available in <odesi>
*ICD-10 - International Statistical Classification of Diseases and Related Health Problems, 10th revision
*CCI – Canadian Classification of Health Interventions
DLI DAD Sample Files
Enhanced Data File
Problems in DAD files as distributed by CIHI
• Primarily string variables – poses analytical problems and problems for STATA
users
• No value labels
• ICD10 and CCI variables have non-alphabetic characters stripped
• e.g. ICD-10 code of A05.80 is in distributed file as A0580; CCI code of
1.AB.86.ML-XX-A is recorded as 1AB86MLXXA
• Difficulties in matching codes to the documentation
• Files contain up to 25 ICD-10 classifications and up to 20 CCI classifications per
record; users may have trouble identifying records in which they are interested
DLI DAD Sample Files
Enhanced Data File
Enhancements to address problems – Clinical file
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Creation of 435 flag variables – users can select records that have a broad
category of ICD-10 and CCI codes, based on first three characters
Created 2 variables that record the number of ICD-10 and CCI codes on
each record (ICDCOUNT; CCICOUNT)
Common disease names added to ICD-10 coding (e.g. chicken pox, measles)
Values of the IDC-10 and CCI variables modified (punctuation added back)
• e.g ICD-10 code A0580 now is A05.80
Frequencies for ICD-10 and CCI variables provided
DLI DAD Sample Files
Enhanced Data File
Enhancements to address problems – Clinical and Geographic files
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String variables converted to code
Value labels added
Questions