Hospitalizations and deaths: Methodology

The hospitalization and deaths component of the BC alcohol and other drug monitoring project estimates deaths and hospitalizations related to alcohol, illicit drugs, and tobacco. Such data allows for comparisons of the total burden of deaths and disease attributable to alcohol, illicit drugs and tobacco between regions and over time.

Key findings from this component can be found in facts & stats/substance-related hospitalizations and deaths in BC. Data tables can be downloaded via the AOD Trend Analyzer.

Our interactive trend analyzer allows you to explore and compare the impacts and statistical trends of alcohol, tobacco, and other drug use for different groups of people in different parts of BC.

Methodology

Ethics approval was obtained from the University of British Columbia, Behavioural Research Ethics Board (H06-04043). Mortality and hospital data were received from BC Vital Statistics and BC Ministry of Health (respectively) by age group, sex, health authority, health services delivery area, local health area and year. All data are securely held at BC Centre for Disease Control. The underlying cause of death code (UCOD) and the most responsible diagnosis code (MRD) were used in the computation of alcohol, tobacco, and illicit drug attributable mortality and morbidity respectively. For hospital data, the diagnosis code indicating a cause of injury (E-CODE) were used to assess (1) injuries and overdoses attributable to alcohol and illicit drugs and (2) toxic effect and fires attributable to tobacco. All rates were standardized by age and sex using the 2001 BC population as the standard population.

Attributable Fractions

The values for the attributable fractions (AF) for tobacco and illicit drugs were taken directly from the report “The Costs of Substance Abuse in Canada 2002” by Jurgen Rehms et al.. The initial values for the AFs for alcohol (for 2002) were also taken directly from “The Costs of Substance Abuse in Canada 2002”. For alcohol AFs for years after 2002, the alcohol AFs were adjusted using BC consumption data. BC per capita consumption was taken from the alcohol consumption component of the BC AOD monitoring project. The data from this component, however, does not reflect unrecorded alcohol consumption. A further 10% was added to the BC per capita consumption data to account for unrecorded alcohol consumption. New alcohol AFs were then estimated using the following formula:

where,
x = year > 2002
AFx = estimated alcohol attributable fraction for the population of interest for year x
AFref = alcohol attributable fraction for the population of interest for reference year (2002)
F = change factor in per capita consumption from reference year to year of interest
for
F = (PCCref -­ PCCx) / (PCCref * -1)
where,
PCCref = per capita consumption for reference year (eg. Rehm et al. used 9.77 for 2002), and
PCCx = per capita consumption for year of interest
Those interested in how the AFs for tobacco and illicit drugs and the initial AFs for alcohol were calculated should refer to “The Costs of Substance Abuse in Canada 2002” by Jurgen Rehms et al.

This project uses the same ICD 10 tables for alcohol, tobacco and illicit drugs that were used in Jurgen Rehm’s project.

Permission to share these results was obtained from the BC Ministry of Health Data Steward and the BC Provincial Health Officer.

Team

Dr. Jane Buxton MBBS, FRCPC
Associate Professor, School of Population and Public Health, UBC
Physician Epidemiologist, BC Centre for Disease Control

Dr. Andrew Tu
Research Assistant, BC Centre for Disease Control

Andrew is currently working at the BCCDC as a research assistant to Dr. Jane Buxton. He is responsible for creating the databases for the mortality and morbidity component of the monitoring system and analyzing the data. Andrew recently completed his PhD in the School of Population and Public Health at UBC. His research topic is identifying BMI trajectories in adolescents from psychosocial factors. He is also interested in exploring psychosocial factors associated with eating behaviours.

Ms. Mei Chong
Biostatistician, Communicable Disease Prevention and Control Services, BCCDC

Mei received her Master Degree in Statistics from Dalhousie University. She is Biostatistician at the BC Center for Disease Control with over 15 years of experience in statistical modeling, clinical trial, and data management. Outside her work life, Mei is also an active volunteer. She chairs the Sponsoring Committee of a local Royal Canadian Air Cadet Squadron, teaches Sunday School at her church, and sits on the executive board of Vancouver SAS User Group Committee and her children’s school PAC.

Dr. Robert Balshaw
Statistical Lead, BCCDC

Dr. Robert Balshaw is Senior Scientist at the BC Centre for Disease Control (BCCDC), and has 20 years of research and industry experience in informatics, biomedical statistics and healthcare outcomes analysis within the healthcare and medical sectors. Dr. Balshaw received his Doctorate in Statistics from Simon Fraser University in Canada and a prestigious Post Doctoral Fellowship from the National Science and Engineering Research Council of Canada.

John Dorocicz

Resource Library

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