In fiscal year, a standard hospital stay in Canada cost on average ***** Canadian dollars. This is the cost for the hospital to treat the average acute inpatient that year. Cost for a hospital stay ranged from ***** in Ontario to ****** in the Northwest Territories.

The average costs to treat a mental health or addiction disorder in Canada varies greatly depending upon the type disorder. As of ********* schizophrenic and psychotic disorders were the most costly to treat. With an average cost of ****** Canadian dollars per hospital stay, it was significantly more costly than many of the other disorders.

Few studies have evaluated the mortality or quantified the economic burden of community-onset Clostridium difficile infection (CDI). We estimated the attributable mortality and costs of community-onset CDI. We conducted a population-based matched cohort study. We identified incident subjects with community-onset CDI using health administrative data (emergency department visits and hospital admissions) in Ontario, Canada between January 1, 2003 and December 31, 2010. We propensity-score matched each infected subject to one uninfected subject and followed subjects in the cohort until December 31, 2011. We evaluated all-cause mortality and costs (unadjusted and adjusted for survival) from the healthcare payer perspective (2014 Canadian dollars). During our study period, we identified 7,950 infected subjects. The mean age was 63.5 years (standard deviation = 22.0), 62.7% were female, and 45.0% were very high users of the healthcare system. The relative risk for 30-day, 180-day, and 1-year mortality were 7.32 (95% confidence interval [CI], 5.94–9.02), 3.55 (95%CI, 3.17–3.97), and 2.59 (95%CI, 2.37–2.83), respectively. Mean attributable cumulative 30-day, 180-day, and 1-year costs (unadjusted for survival) were $7,434 (95%CI, $7,122-$7,762), $12,517 (95%CI, $11,687-$13,366), and $13,217 (95%CI, $12,062-$14,388). Mean attributable cumulative 1-, 2-, and 3-year costs (adjusted for survival) were $10,700 (95%CI, $9,811-$11,645), $13,312 (95%CI, $12,024-$14,682), and $15,812 (95%CI, $14,159-$17,571). Infected subjects had considerably higher risk of all-cause mortality and costs compared with uninfected subjects. This study provides insight on an understudied patient group. Our study findings will facilitate assessment of interventions to prevent community-onset CDI.

Clostridium difficile Infection (CDI) rates while in hospital are measured and monitored by infection prevention and control staff as a means to evaluate the effectiveness of their infection control protocols. CDI rates are calculated by dividing the number of clostridium difficile infections by the total number of patient days. This rate is then multiplied by 10,000 to make a standard CDI infection rate for each reporting period. The rate is reported per 10,000 patient days. The Canadian benchmark CDI rate is included in the dataset. Data fields include: Year, Quarter, Health Authority, Health Authority Zone, CDI Rate, Canadian benchmark

Clostridium difficile Infection (CDI) rates while in hospital are measured and monitored by infection prevention and control staff as a means to evaluate the effectiveness of their infection control protocols. CDI rates are calculated by dividing the number of clostridium difficile infections by the total number of patient days. This rate is then multiplied by 10,000 to make a standard CDI infection rate for each reporting period. The rate is reported per 10,000 patient days. The Canadian benchmark CDI rate is included in the dataset. Data fields include: Year, Quarter, Health Authority, Health Authority Zone, CDI Rate, Canadian benchmark

*Data from Quebec and Alberta are not included.N/A – not applicable.Note. In instances where there were fewer than five cases (<5), a midpoint of 2.5 was imputed on those cells. As a result, there may be rounding errors after collapsing the numbers.Source: CIHI, 2011 (DAD, HMDB, NACRS, OMHRS).

These are peer-reviewed supplementary materials for the article 'The economic impact of stent retriever selection for acute ischemic stroke: a cost analysis of MASTRO I from the healthcare system perspective of the United States, Canada and eight European countries' published in the Journal of Comparative Effectiveness Research.Supplementary Tables and FiguresSupplementary Table 1: Economic Outcomes of Probabilistic Scenario Analyses Supplementary Figure 1: Tornado Diagrams for Per-Patient Incremental Cost – US AnalysisSupplementary Figure 2: Tornado Diagrams for Per-Patient Incremental Cost – Canada AnalysisSupplementary Figure 3: Tornado Diagrams for Per-Patient Incremental Cost – UK AnalysisSupplementary Figure 4: Tornado Diagrams for Per-Patient Incremental Cost – Sweden AnalysisSupplementary Figure 5: Tornado Diagrams for Per-Patient Incremental Cost – Germany AnalysisSupplementary Figure 6: Tornado Diagrams for Per-Patient Incremental Cost – France AnalysisSupplementary Figure 7: Tornado Diagrams for Per-Patient Incremental Cost – Italy AnalysisSupplementary Figure 8: Tornado Diagrams for Per-Patient Incremental Cost – Spain AnalysisSupplementary Figure 9: Tornado Diagrams for Per-Patient Incremental Cost – Belgium AnalysisSupplementary Figure 10: Tornado Diagrams for Per-Patient Incremental Cost – The Netherlands AnalysisSupplementary MethodsCost Inputs for GermanyCost Inputs for FranceCost Inputs for The NetherlandsSupplementary Material ReferencesAim: According to the results of the MASTRO I living systematic review and meta-analysis, use of the EmboTrap Revascularization Device in the treatment of acute ischemic stroke (AIS) results in higher rates of good functional outcomes (90-day modified Rankin Scale [mRS] 0–2) compared with use of the Trevo Retriever or the Solitaire™ Revascularization Device. The aim of this analysis was to assess the potential economic impact of achieving improved functional outcomes for three commonly used stent retrievers (SRs) in the treatment of AIS. Methods: An economic modelwith short-term and long-term costs, representing a healthcare system perspective was developed using a decision tree to simulate a cohort of 1000 hypothetical patients treated for AIS with mechanical thrombectomy (MT) using EmboTrap, Trevo or Solitaire SRs. Based on the proportion of patients who achieved a 90-day mRS score of 0–2 or 3–5 for each device reported in MASTRO I (excluding patients not surviving after 90 days), this model estimated per-patient costs and the associated incremental cost savings. Results are reported from the healthcare system perspective in the US, Canada, the UK, Sweden, Germany, France, Italy, Spain, Belgium and The Netherlands. Results: Across all ten countries, the use of EmboTrap during MT was associated with the lowest short-term (ranging from €8412 in Italy to $66,525 in the US), long-term (ranging from €5249 in Italy to $25,757 in the US) and total (ranging from €13,661 in Italy to $92,282 in the US) per-patient costs. The total per-patient cost was higher with Trevo (ranging from €14,601 in Italy to $97,487 in the US) and Solitaire (ranging from €14,840 in Italy to $98,814 in the US). Cost savings were highest when comparing EmboTrap versus Solitaire, followed by EmboTrap versus Trevo, with Trevo versus Solitaire having the smallest cost savings. Results of sensitivity and scenario analyses supported the robustness of the basecase results. Conclusion: Across the ten countries, treating patients with AIS with EmboTrap resulted in lower short-term, long-term and total costs to the payer. With rising healthcare costs and limited hospital budgets, these results suggest EmboTrap proves to be an evidence-based economical choice of SR for hospitals and healthcare systems.

ObjectiveTo develop person-centered episodes of care (PCE) for community-dwelling individuals in the top fifth percentile of Ontario health care expenditures in order to: (1) describe the main clinical groupings for spending; and (2) identify patterns of spending by health sector (e.g. acute care, home care, physician billings) within and across PCE.Data sourcesData were drawn from population-based administrative databases for all publicly funded health care in Ontario, Canada in 2010/11.Study designThis study is a retrospective cohort study.Data collection/extraction methodsA total of 587,982 community-dwelling individuals were identified among those accounting for the top 5% of provincial health care expenditures between April 1, 2010 and March 31, 2011. PCE were defined as starting with an acute care admission and persisting through subsequent care settings and providers until individuals were without health system contact for 30 days. PCE were classified according to the clinical grouping for the initial admission. PCE and non-PCE costs were calculated and compared to provide a comprehensive measurement of total health system costs for the year.Principal findingsAmong this community cohort, 697,059 PCE accounted for nearly 70% ($11,815.3 million (CAD)) of total annual publicly-funded expenditures on high-cost community-dwelling individuals. The most common clinical groupings to start a PCE were Acute Planned Surgical (35.2%), Acute Unplanned Medical (21.0%) and Post-Admission Events (10.8%). Median PCE costs ranged from $3,865 (IQR = $1,712-$10,919) for Acute Planned Surgical to $20,687 ($12,207-$39,579) for Post-Admission Events. Inpatient acute ($8,194.5 million) and inpatient rehabilitation ($434.6 million) health sectors accounted for the largest proportions of allocated PCE spending over the year.ConclusionsOur study provides a novel methodological approach to categorize high-cost health system users into meaningful person-centered episodes. This approach helps to explain how costs are attributable within individuals across sectors and has applications in episode-based payment formulas and quality monitoring.

Methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection rates while in hospital are measured and monitored by infection prevention and control staff as a means to evaluate the effectiveness of their infection control protocols. MRSA rates are calculated by dividing the number of clostridium difficile infections by the total number of patient days. This rate is then multiplied by 10,000 to make a standard MRSA infection rate for each reporting period. The rate is reported per 10,000 patient days. The Canadian benchmark MRSA rate is included in the dataset. Data fields include: Year, Quarter, Health Authority, Health Authority Zone, MRSA Rate, Canadian benchmark.

Background: Substantial mortality occurs after hospital discharge in children younger than 5 years with suspected sepsis, especially in low-income countries. A better understanding of its epidemiology is needed for effective interventions to reduce child mortality in these countries. We evaluated risk factors for death after discharge in children admitted to hospital for suspected sepsis in Uganda, and assessed how these differed by age, time of death, and location of death. Methods: In this prospective observational cohort study, we recruited 0-60-month-old children admitted with suspected sepsis from the community to the paediatric wards of six Ugandan hospitals. The primary outcome was six-month post-discharge mortality among those discharged alive. We evaluated the interactive impact of age, time of death, and location of death on risk factors for mortality. Findings: 6,545 children were enrolled, with 6,191 discharged alive. The median (interquartile range) time from discharge to death was 28 (9-74) days, with a six-month post-discharge mortality rate of 5·5%, constituting 51% of total mortality. Deaths occurred at home (45%), in-transit to care (18%), or in hospital (37%) during a subsequent readmission. Post-discharge death was strongly associated with weight-for-age z-scores < -3 (adjusted risk ratio [aRR] 4·7, 95% CI 3·7–5·8 vs a Z score of >–2), referral for further care (7·3, 5·6–9·5), and unplanned discharge (3·2, 2·5–4·0). The hazard ratio of those with severe anaemia increased with time since discharge, while the hazard ratios of discharge vulnerabilities (unplanned, poor feeding) decreased with time. Age influenced the effect of several variables, including anthropometric indices (less impact with increasing age), anaemia (greater impact), and admission temperature (greater impact). Data Collection Methods: All data were collected at the point of care using encrypted study tablets and these data were then uploaded to a Research Electronic Data Capture (REDCap) database hosted at the BC Children’s Hospital Research Institute (Vancouver, Canada). At admission, trained study nurses systematically collected data on clinical, social and demographic variables. Following discharge, field officers contacted caregivers at 2 and 4 months by phone, and in-person at 6 months, to determine vital status, post-discharge health-seeking, and readmission details. Verbal autopsies were conducted for children who had died following discharge. Data Processing Methods: For this analysis, data from both cohorts (0-6 months and 6-60 months) were combined and analysed as a single dataset. We used periods of overlapping enrolment (72% of total enrolment months) between the two cohorts to determine site-specific proportions of children who were 0-6 and 6-60 months of age. These proportions were used to weight the cohorts for the calculation of overall mortality rate. Z-scores were calculated using height and weight. Hematocrit was converted to hemoglobin. Distance to hospital was calculated using latitude and longitude. Extra symptom and diagnosis categories were created based on text field in these two variables. BCS score was created by summing all individual components. Abbreviations: MUAC -mid upper arm circumference wfa – weight for age wfl – weight for length bmi – body mass index lfa – length for age abx - antibiotics hr – heart rate rr – respiratory rate antimal - antimalarial sysbp – systolic blood pressure diasbp – diastolic blood pressure resp – respiratory cap - capillary BCS - Blantyre Coma Scale dist- distance hos - hospital ed - education disch - discharge dis -discharge fu – follow-up pd – post-discharge loc - location materl - maternal Ethics Declaration: This study was approved by the Mbarara University of Science and Technology Research Ethics Committee (No. 15/10-16), the Uganda National Institute of Science and Technology (HS 2207), and the University of British Columbia / Children & Women’s Health Centre of British Columbia Research Ethics Board (H16-02679). This manuscript adheres to the guidelines for STrengthening the Reporting of OBservational studies in Epidemiology (STROBE). Study Protocol & Supplementary Materials: Smart Discharges to improve post-discharge health outcomes in children: A prospective before-after study with staggered implementation, NOTE for restricted files: If you are not yet a CoLab member, please complete our membership application survey to gain access to restricted files within 2 business days. Some files may remain restricted to CoLab members. These files are deemed more sensitive by the file owner and are meant to be shared on a case-by-case basis. Please contact the CoLab coordinator at sepsiscolab@bcchr.ca or visit our website.

Methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection rates while in hospital are measured and monitored by infection prevention and control staff as a means to evaluate the effectiveness of their infection control protocols. MRSA rates are calculated by dividing the number of clostridium difficile infections by the total number of patient days. This rate is then multiplied by 10,000 to make a standard MRSA infection rate for each reporting period. The rate is reported per 10,000 patient days. The Canadian benchmark MRSA rate is included in the dataset. Data fields include: Year, Quarter, Health Authority, Health Authority Zone, MRSA Rate, Canadian benchmark.

The B.C. COVID-19 Dashboard has been retired and will no longer be updated.Purpose: These data can be used for visual or reference purposes.British Columbia COVID-19 B.C. & Canadian Testing Rates are obtained from the Public Health Agency of Canada’s Daily Epidemiologic Update site: https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html.These data were made specifically for the British Columbia COVID-19 Dashboard.

Terms of use, disclaimer and limitation of liabilityAlthough every effort has been made to provide accurate information, the Province of British Columbia, including the British Columbia Centre for Disease Control, the Provincial Health Services Authority and the British Columbia Ministry of Health makes no representation or warranties regarding the accuracy of the information in the dashboard and the associated data, nor will it accept responsibility for errors or omissions. Data may not reflect the current situation, and therefore should only be used for reference purposes. Access to and/or content of these data and associated data may be suspended, discontinued, or altered, in part or in whole, at any time, for any reason, with or without prior notice, at the discretion of the Province of British Columbia.Anyone using this information does so at his or her own risk, and by using such information agrees to indemnify the Province of British Columbia, including the British Columbia Centre for Disease Control, the Provincial Health Services Authority and the British Columbia Ministry of Health and its content providers from any and all liability, loss, injury, damages, costs and expenses (including legal fees and expenses) arising from such person’s use of the information on this website.Dashboard Updates - GeneralData are updated up to the previous Saturday. Weekly metrics reflect the latest full week, Sunday to Saturday. The “Currently Hospitalized” and “Currently in Critical Care” reflect daily volumes on the Thursday.Data Notes - GeneralThe following data notes define the indicators presented on the public dashboard and describe the data sources involved. Data changes as new cases are identified, characteristics of reported cases change or are updated, and data corrections are made. Specific values may therefore fluctuate in response to underlying system changes. As such, case, hospitalization, deaths, testing and vaccination counts and rates may not be directly comparable to previously published reports. For the latest caveats about the data, please refer to the most recent BCCDC Surveillance Report located at: www.bccdc.ca/health-info/diseases-conditions/covid-19/dataData SourcesLaboratory data are supplied by the B.C. Centre for Disease Control (BCCDC) Public Health Laboratory; tests performed for other provinces have been excluded. See “Data Over Time” for more information on changes to the case definition.Total COVID-19 cases include lab-confirmed, lab-probable and epi-linked cases. Case definitions can be found at: https://www.bccdc.ca/health-professionals/clinical-resources/case-definitions/covid-19-(novel-coronavirus). Currently hospitalized and critical care hospitalizations data are received from Provincial COVID-19 Monitoring Solution, Provincial Health Services Authority. See “Data Over Time” for more information on previous data sources.Vaccine data are received from the B.C. Ministry of Health.Mortality data are received from Vital Statistics, B.C. Ministry of Health. See Data Over Time for more information on precious data sources.Laboratory data is supplied by the B.C. Centre for Disease Control Public Health Laboratory and the Provincial Lab Information Solution (PLIS); tests performed for other provinces have been excluded.Critical care hospitalizations are provided by the health authorities to PHSA on a daily basis. BCCDC/PHSA/B.C. Ministry of Health data sources are available at the links below:Cases Totals (spatial)Case DetailsLaboratory Testing InformationRegional Summary DataData Over TimeThe number of laboratory tests performed and positivity rate over time are reported by the date of test result. See “Laboratory Indicators” section for more details.Laboratory confirmed cases are reported based on the client's first positive lab result.As of April 2, 2022, cases include laboratory-diagnosed cases (confirmed and probable) funded under Medical Services Plan.From January 7, 2021 to April 1, 2022, cases included those reported by the health authorities and those with positive laboratory results reported to the BCCDC. The number of cases over time is reported by the result date of the client's first positive lab result where available; otherwise by the date they are reported to public health. Prior to April 2, 2022, total COVID-19 cases included laboratory-diagnosed cases (confirmed and probable) as well as epi-linked cases. Prior to June 4, 2020, the total number of cases included only laboratory-diagnosed cases.As of January 14, 2022, the data source for "Currently Hospitalized" has changed to better reflect hospital capacity. Comparisons to numbers before this date should not be made.As of April 2, 2022, death is defined as an individual who has died from any cause, within 30 days of a first COVID-19 positive lab result date. Prior to April 22, 2022, death information was collected by Regional Health Authorities and defined as any death related to COVID-19. Comparisons between these time periods are not advised.Epidemiologic Indicators"Currently Hospitalized" is the number of people who test positive for COVID-19 through hospital screening practices, regardless of the reason for admission, as recorded in PCMS on the day the dashboard is refreshed. It is reported by the hospital in which the patient is hospitalized, rather than the patient's health authority of residence.Critical care values (intensive care units, high acuity units, and other critical care surge beds) include individuals who test positive for COVID-19 and are in critical care, as recorded in PCMS.The 7-day moving average is an average daily value over the 7 days up to and including the selected date. The 7-day window moved - or changes - with each new day of data. It is used to smooth new daily case and death counts or rates to mitigate the impact of short-term fluctuations and to more clearly identify the most recent trend over time.The following epidemiological indicators are included in the provincial case data file:Date: date of the client's first positive lab result.HA: health authority assigned to the caseSex: the sex of the clientAge_Group: the age group of the clientClassification_Reported: whether the case has been lab-diagnosed or is epidemiologically linked to another caseThe following epidemiological indicators are included in the regional summary data file:Cases_Reported: the number of cases for the health authority (HA) and health service delivery area (HSDA)Cases_Reported_Smoothed: Seven day moving average for reported casesLaboratory IndicatorsTests represent the number of all COVID-19 tests reported to the BCCDC Public Helath Laboratory since testing began mid-January 2020. Only tests for residents of B.C. are included.COVID-19 positivity rate is calculated for each day as the ratio of 7-day rolling average of number of positive specimens to 7-day rolling average of the total number of specimens tested (positive, negative, indeterminate and invalid). A 7-day rolling average applied to all testing data corrects for uneven data release patterns while accurately representing the provincial positivity trends. It avoids misleading daily peaks and valleys due to varying capacities and reporting cadences.Turn-around time is calculated as the daily average time (in hours) between specimen collection and report of a test result. Turn-around time includes the time to ship specimens to the lab; patients who live farther away are expected to have slightly longer average turn around times.The rate of COVID-19 testing per million population is defined as the cumulative number of people tested for COVID-19/B.C. population x 1,000,000. B.C. Please note: the same person may be tested multiple times, thus it is not possible to derive this rate directly from the number of cumulative tests reported on the B.C. COVID-19 Dashboard.Testing context: COVID-19 diagnostic testing and laboratory test guidelines have changed in British Columbia over time. B.C.'s testing strategy has been characterized by four phases: 1) Exposure-based testing (start of pandemic), 2) Targeted testing (March 16, 2020), 3) Expanded testing (April 9, 2020), 4) Symptom-based testing (April 21, 2020), and 5) Symptom-based testing for targeted populations (a-are at risk of more severe disease and/or b-live or work in high-risk settings such as healthcare workers) and Rapid Antigen Tests deployment (January 18, 2022). Due to changes in testing strategies in BC in 2022, focusing on targeted higher risk populations, current case counts are an underestimate of the true number of COVID-19 cases in BC and may not be representative of the situation in the community.
The following laboratory indicators are included in the provincial laboratory data file:New_Tests: the number of new COVID-19 testsTotal_Tests: the total number of COVID-19 testsPositivity: the positivity rate for COVID-19 testsTurn_Around: the turnaround time for COVID-19 testsBC Testing Rate: Total PCR + POC tests per day (excluding POC that were confirmed by PCR within 7 days) / Population using BC Stats PEOPLE2021 population projections for the year 2022 * 100,000.Health Authority AssignmentCases are reported by health authority of residence.As of April 2, 2022, cases are reported based on the address provided at the time of testing; when not available, by location of the provider ordering the lab test.As of April 2, 2022, cases who reported having an address outside of B.C. are not included.Prior to April 2, 2022, when

**Effective November 14, 2024 this page will no longer be updated. Information about COVID-19 and other respiratory viruses is available on Public Health Ontario’s interactive respiratory virus tool: https://www.publichealthontario.ca/en/Data-and-Analysis/Infectious-Disease/Respiratory-Virus-Tool **

As of January 26, 2023, the population counts are based on Statistics Canada’s 2021 estimates. The coverage methodology has been revised to calculate age based on the current date and deceased individuals are no longer included. The method used to count daily dose administrations has changed is now based on the date delivered versus the day entered into the data system. Historical data has been updated.

Please note that Cases by Vaccination Status data will no longer be published as of June 30, 2022.

Please note that case rates by vaccination status and age group data will no longer be published as of July 13, 2022.

Please note that Hospitalization by Vaccination Status data will no longer be published as of June 30, 2022.

Learn more about COVID-19 vaccines.

Data includes:

• daily and total doses administered
• individuals with at least one dose
• individuals fully vaccinated
• total doses given to fully vaccinated individuals
• vaccinations by age
• percentage of age group
• individuals with at least one dose, by PHU, by age group
• individuals fully vaccinated, by PHU, by age group
• COVID-19 cases by status: not fully vaccinated, fully vaccinated, vaccinated with booster
• individuals in hospital due to COVID-19 (excluding ICU) by status: unvaccinated, partially vaccinated, fully vaccinated
• individuals in ICU due to COVID-19 by status: unvaccinated, partially vaccinated, fully vaccinated, unknown
• rate of COVID-19 cases per 100,000 by status and age group
• rate per 100,000 (7-day average) by status and age group

All data reflects totals from 8 p.m. the previous day.

This dataset is subject to change.

Additional notes

• Data entry of vaccination records is still in progress, therefore the dosage data may not be a full representation of all vaccination doses administered in Ontario.
• The data does not include dosage data where consent was not provided for vaccination records to be entered into the provincial CoVax system. This includes individual records as well as records from some Indigenous communities where those communities have not consented to including vaccination information into CoVax.

Hospitalizations and cases by vaccination status

Hospitalizations

• This is a new data collection and the data quality will continue to improve as hospitals continue to submit data.
• In order to understand the vaccination status of patients currently hospitalized, a new data collection process was developed and this may cause discrepancies between other hospitalization numbers being collected using a different data collection process.
• Data on patients in ICU are being collected from two different data sources with different extraction times and public reporting cycles. The existing data source (Critical Care Information System, CCIS) does not have vaccination status.
• Historical data for hospitalizations by region may change over time as hospitals update previously entered data.
• Due to incomplete weekend and holiday reporting, vaccination status data for hospital and ICU admissions is not updated on Sundays, Mondays and the day after holidays
• Unvaccinated is defined as not having any dose, or between 0-13 days after administration of the first dose of a COVID-19 vaccine.
• Partially vaccinated is defined as 14 days or more after the first dose of a 2-dose series COVID-19 vaccine, or between 0-13 days after administration of the second dose
• Fully vaccinated is defined as 14 days or more after receipt of the second dose of a 2-dose series COVID-19 vaccine

Cases

• The cases by vaccination status may not match the daily COVID-19 case count because records with a missing or invalid health card number cannot be linked.

IntroductionHip and knee replacement surgery is one of the most commonly performed elective procedures, accounting for significant healthcare costs and resource utilization. In recent years, the proportion of hip and knee arthroplasties performed in outpatient settings has grown rapidly. Although the safety and effectiveness of outpatient vs. inpatient hip and knee arthroplasty have been documented in the literature, estimates of health system cost-savings in Canada are limited.MethodsWe employed a population-based retrospective cohort study design. We obtained data on patients aged 18–105 years who underwent hip or knee replacement surgery in both inpatient and outpatient settings in Ontario, Canada between 2018/19 and 2022/23. Patients who underwent outpatient hip and knee arthroplasty were matched to inpatient cases using a propensity score based on age, sex, comorbidity, area-level sociodemographic factors, total/partial replacement, and surgery date. We analyzed cost data that included hospitalization and ambulatory care visits, physician billing, home care, and oral medications. We utilized generalized linear models to identify the best fit regression model and estimated the average cost-savings associated with outpatient versus inpatient arthroplasty during the preoperative (30-days before surgery), perioperative (surgery + 30 days), 1–6-month postoperative, 6–12-month postoperative, 12–24-month postoperative, and 24–36-month postoperative periods. The costs were reported in 2023 Canadian dollars.ResultsA total of 35,894 hip arthroplasty patients and 49,597 knee arthroplasty patients were included in our analysis. During the perioperative period, outpatient arthroplasty was less costly than inpatient arthroplasty for hip replacement by $3,859 (95% CI -$4045, -$3745) and for knee replacement by $3,966 ($-4080, $-3851). Over 3 years of follow-up, outpatient arthroplasty was less costly than inpatient arthroplasty for hip replacement by $7058 (-$8086, -$6031) and for knee replacement by $7043 (-$7842, -$6243).ConclusionOutpatient hip and knee arthroplasty is cost-saving both during and beyond the perioperative period in comparison with similar patients who undergo inpatient arthroplasty in Ontario. Policies should be put in place to incentivize continued uptake of outpatient arthroplasty, which we estimate could save the Ontario healthcare system up to $98 million per year.

IntroductionHip and knee replacement surgery is one of the most commonly performed elective procedures, accounting for significant healthcare costs and resource utilization. In recent years, the proportion of hip and knee arthroplasties performed in outpatient settings has grown rapidly. Although the safety and effectiveness of outpatient vs. inpatient hip and knee arthroplasty have been documented in the literature, estimates of health system cost-savings in Canada are limited.MethodsWe employed a population-based retrospective cohort study design. We obtained data on patients aged 18–105 years who underwent hip or knee replacement surgery in both inpatient and outpatient settings in Ontario, Canada between 2018/19 and 2022/23. Patients who underwent outpatient hip and knee arthroplasty were matched to inpatient cases using a propensity score based on age, sex, comorbidity, area-level sociodemographic factors, total/partial replacement, and surgery date. We analyzed cost data that included hospitalization and ambulatory care visits, physician billing, home care, and oral medications. We utilized generalized linear models to identify the best fit regression model and estimated the average cost-savings associated with outpatient versus inpatient arthroplasty during the preoperative (30-days before surgery), perioperative (surgery + 30 days), 1–6-month postoperative, 6–12-month postoperative, 12–24-month postoperative, and 24–36-month postoperative periods. The costs were reported in 2023 Canadian dollars.ResultsA total of 35,894 hip arthroplasty patients and 49,597 knee arthroplasty patients were included in our analysis. During the perioperative period, outpatient arthroplasty was less costly than inpatient arthroplasty for hip replacement by $3,859 (95% CI -$4045, -$3745) and for knee replacement by $3,966 ($-4080, $-3851). Over 3 years of follow-up, outpatient arthroplasty was less costly than inpatient arthroplasty for hip replacement by $7058 (-$8086, -$6031) and for knee replacement by $7043 (-$7842, -$6243).ConclusionOutpatient hip and knee arthroplasty is cost-saving both during and beyond the perioperative period in comparison with similar patients who undergo inpatient arthroplasty in Ontario. Policies should be put in place to incentivize continued uptake of outpatient arthroplasty, which we estimate could save the Ontario healthcare system up to $98 million per year.

The B.C. COVID-19 Dashboard has been retired and will no longer be updated.Purpose: These data can be used for visual or reference purposes.British Columbia, Canada COVID-19 Regional Summary Date are from the British Columbia Centre for Disease Control, Provincial Health Services Authority and the British Columbia Ministry of Health.

These data represent the British Columbia Health Service Delivery Area and Health Authority 7-day Moving Average COVID-19 case data.

These data were made specifically for the British Columbia COVID-19 Dashboard.

Terms of use, disclaimer and limitation of liabilityAlthough every effort has been made to provide accurate information, the Province of British Columbia, including the British Columbia Centre for Disease Control, the Provincial Health Services Authority and the British Columbia Ministry of Health makes no representation or warranties regarding the accuracy of the information in the dashboard and the associated data, nor will it accept responsibility for errors or omissions. Data may not reflect the current situation, and therefore should only be used for reference purposes. Access to and/or content of these data and associated data may be suspended, discontinued, or altered, in part or in whole, at any time, for any reason, with or without prior notice, at the discretion of the Province of British Columbia.Anyone using this information does so at his or her own risk, and by using such information agrees to indemnify the Province of British Columbia, including the British Columbia Centre for Disease Control, the Provincial Health Services Authority and the British Columbia Ministry of Health and its content providers from any and all liability, loss, injury, damages, costs and expenses (including legal fees and expenses) arising from such person’s use of the information on this website.Dashboard Updates - GeneralData are updated up to the previous Saturday. Weekly metrics reflect the latest full week, Sunday to Saturday. The “Currently Hospitalized” and “Currently in Critical Care” reflect daily volumes on the Thursday.Data Notes - GeneralThe following data notes define the indicators presented on the public dashboard and describe the data sources involved. Data changes as new cases are identified, characteristics of reported cases change or are updated, and data corrections are made. Specific values may therefore fluctuate in response to underlying system changes. As such, case, hospitalization, deaths, testing and vaccination counts and rates may not be directly comparable to previously published reports. For the latest caveats about the data, please refer to the most recent BCCDC Surveillance Report located at: www.bccdc.ca/health-info/diseases-conditions/covid-19/dataData SourcesLaboratory data are supplied by the B.C. Centre for Disease Control (BCCDC) Public Health Laboratory; tests performed for other provinces have been excluded. See “Data Over Time” for more information on changes to the case definition.Total COVID-19 cases include lab-confirmed, lab-probable and epi-linked cases. Case definitions can be found at: https://www.bccdc.ca/health-professionals/clinical-resources/case-definitions/covid-19-(novel-coronavirus). Currently hospitalized and critical care hospitalizations data are received from Provincial COVID-19 Monitoring Solution, Provincial Health Services Authority. See “Data Over Time” for more information on previous data sources.Vaccine data are received from the B.C. Ministry of Health.Mortality data are received from Vital Statistics, B.C. Ministry of Health. See Data Over Time for more information on precious data sources.Laboratory data is supplied by the B.C. Centre for Disease Control Public Health Laboratory and the Provincial Lab Information Solution (PLIS); tests performed for other provinces have been excluded.Critical care hospitalizations are provided by the health authorities to PHSA on a daily basis. BCCDC/PHSA/B.C. Ministry of Health data sources are available at the links below:Cases Totals (spatial)Case DetailsLaboratory Testing InformationRegional Summary DataData Over TimeThe number of laboratory tests performed and positivity rate over time are reported by the date of test result. See “Laboratory Indicators” section for more details.Laboratory confirmed cases are reported based on the client's first positive lab result.As of April 2, 2022, cases include laboratory-diagnosed cases (confirmed and probable) funded under Medical Services Plan.From January 7, 2021 to April 1, 2022, cases included those reported by the health authorities and those with positive laboratory results reported to the BCCDC. The number of cases over time is reported by the result date of the client's first positive lab result where available; otherwise by the date they are reported to public health. Prior to April 2, 2022, total COVID-19 cases included laboratory-diagnosed cases (confirmed and probable) as well as epi-linked cases. Prior to June 4, 2020, the total number of cases included only laboratory-diagnosed cases.As of January 14, 2022, the data source for "Currently Hospitalized" has changed to better reflect hospital capacity. Comparisons to numbers before this date should not be made.As of April 2, 2022, death is defined as an individual who has died from any cause, within 30 days of a first COVID-19 positive lab result date. Prior to April 22, 2022, death information was collected by Regional Health Authorities and defined as any death related to COVID-19. Comparisons between these time periods are not advised.Epidemiologic Indicators"Currently Hospitalized" is the number of people who test positive for COVID-19 through hospital screening practices, regardless of the reason for admission, as recorded in PCMS on the day the dashboard is refreshed. It is reported by the hospital in which the patient is hospitalized, rather than the patient's health authority of residence.Critical care values (intensive care units, high acuity units, and other critical care surge beds) include individuals who test positive for COVID-19 and are in critical care, as recorded in PCMS.The 7-day moving average is an average daily value over the 7 days up to and including the selected date. The 7-day window moved - or changes - with each new day of data. It is used to smooth new daily case and death counts or rates to mitigate the impact of short-term fluctuations and to more clearly identify the most recent trend over time.The following epidemiological indicators are included in the provincial case data file:Date: date of the client's first positive lab result.HA: health authority assigned to the caseSex: the sex of the clientAge_Group: the age group of the clientClassification_Reported: whether the case has been lab-diagnosed or is epidemiologically linked to another caseThe following epidemiological indicators are included in the regional summary data file:Cases_Reported: the number of cases for the health authority (HA) and health service delivery area (HSDA)Cases_Reported_Smoothed: Seven day moving average for reported casesLaboratory IndicatorsTests represent the number of all COVID-19 tests reported to the BCCDC Public Helath Laboratory since testing began mid-January 2020. Only tests for residents of B.C. are included.COVID-19 positivity rate is calculated for each day as the ratio of 7-day rolling average of number of positive specimens to 7-day rolling average of the total number of specimens tested (positive, negative, indeterminate and invalid). A 7-day rolling average applied to all testing data corrects for uneven data release patterns while accurately representing the provincial positivity trends. It avoids misleading daily peaks and valleys due to varying capacities and reporting cadences.Turn-around time is calculated as the daily average time (in hours) between specimen collection and report of a test result. Turn-around time includes the time to ship specimens to the lab; patients who live farther away are expected to have slightly longer average turn around times.The rate of COVID-19 testing per million population is defined as the cumulative number of people tested for COVID-19/B.C. population x 1,000,000. B.C. Please note: the same person may be tested multiple times, thus it is not possible to derive this rate directly from the number of cumulative tests reported on the B.C. COVID-19 Dashboard.Testing context: COVID-19 diagnostic testing and laboratory test guidelines have changed in British Columbia over time. B.C.'s testing strategy has been characterized by four phases: 1) Exposure-based testing (start of pandemic), 2) Targeted testing (March 16, 2020), 3) Expanded testing (April 9, 2020), 4) Symptom-based testing (April 21, 2020), and 5) Symptom-based testing for targeted populations (a-are at risk of more severe disease and/or b-live or work in high-risk settings such as healthcare workers) and Rapid Antigen Tests deployment (January 18, 2022). Due to changes in testing strategies in BC in 2022, focusing on targeted higher risk populations, current case counts are an underestimate of the true number of COVID-19 cases in BC and may not be representative of the situation in the community.
The following laboratory indicators are included in the provincial laboratory data file:New_Tests: the number of new COVID-19 testsTotal_Tests: the total number of COVID-19 testsPositivity: the positivity rate for COVID-19 testsTurn_Around: the turnaround time for COVID-19 testsBC Testing Rate: Total PCR + POC tests per day (excluding POC that were confirmed by PCR within 7 days) / Population using BC Stats PEOPLE2021 population projections for the year 2022 * 100,000.Health Authority AssignmentCases are reported by health authority of residence.As of April 2, 2022, cases are reported based on the address provided at the time of testing; when not available, by location of the provider ordering the lab test.As of April 2, 2022,