Sunday, March 22, 2020

Canadian abortion statistics: who does, and who does not, report medical abortions

This is an update of all the different kinds of abortions reported by CIHI, vs the provinces. (Further to this post which is starting to confuse even me.)

CIHI only reports these abortions: S752 - induced - by any surgical technique up to and including 14 weeks gestation, S785 - induced - by any surgical technique after 14 weeks of gestation (CIHI does not report medical abortions)

Quebec Health has confirmed that their abortion numbers do not include medical abortions.

Alberta Health has confirmed that their abortion numbers do not include medical abortions.

Ontario Ministry of Health and Long Term Care does report medical abortions:

MOHLTC reports all these types of abortions (at this point Ontario has the most comprehensive reporting of abortion numbers in Canada):
A920A - MEDICAL MANAGEMENT OF EARLY PREGNANCY - INITIAL VISIT (medical abortions)
P001A MEDICAL MGMT FETAL DEMISE BETWEEN 14-20 WKS GESTATION
P054A FETAL MANAGEMENT-SGL/MULT-INTRACARDIAC KCL INJECTION
S752A FEM.GENITAL SYST.-INDUCED-CURRETINTRA-AMNIOTIC INJ.
S770A CORPUS UTERI - HYSTEROTOMY.
S783A CORPUS UTERI - HYSTEROTOMY WITH TUBAL INTERRUPTION.
S785A FEM.GENITAL SYST.-INDUCED-INTRA-AMNIOTIC INJ. (INCOMP.)

BC does report medical abortions

Monday, March 9, 2020

Canada abortion rates by province

Ideally I would have used actual abortion numbers from each province, and had actual numbers from CIHI. But that seems like an impossible dream. We know Alberta is under reports because they don't count medical abortions. We know that CIHI also isn't reporting medical abortions. We know that Quebec and Ontario under report their abortions by 20%. And that's just what we know, we don't know.

So instead I just used CIHI's numbers.

Wednesday, March 4, 2020

The never ending story of abortion statistics in Canada

Further to my post on Canada's abortion statistics, I have done a four year comparison between CIHI's and Ontario's abortion numbers. As you can see the spread between CIHI's and MOHLTC's numbers increase every year between (2014 and 2014/2015), to (2017 and 2017/2018). So while overall the numbers are decreasing, the spread is getting larger. In 2014 and 2014/2015, the difference was 8.4%. In 2017 and 2017/2018 the difference was 20.42%. 

Adding 20.42% (to CIHI's reported 85,195 in 2018 for all of Canada) would mean a total of at least 102,592 abortions for all of Canada. 

See above link for my notes from CIHI and MOHLTC.

Alberta abortion codes

Further to this FOI I did for Alberta, I received this from Alberta Health Services regarding the claim codes that are used for abortions.

'86.41',,'87.0 ','87.1','87.21','87.29A','87.29B'

More information on the code meaning can be found in this link

86.4 Other removal of embryo
86.41 Hysterotomy to terminate pregnancy

87.0 Intra-amniotic injection for termination of pregnancy
87.0 A Termination of pregnancy between 13 and 20 weeks for medical or genetic reasons using potent prostaglandins by any route
NOTE: 1. Includes the insertion of a laminaria tent if required.
2. A D & C required within 14 days should be claimed under 81.09.

87.2 Other termination of pregnancy
87.29 Other termination of pregnancy NEC
87.29A Suction curettage or dilation and curettage for termination of pregnancy
NOTE: May only be claimed when performed in an active treatment hospital or by a physician approved to perform the procedure by the CPSA when performed in an accredited non-hospital surgical facility.

87.29B Termination of pregnancy, dilatation and evacuation (D&E) termination where imaging report confirms fetus is 12 weeks size or greater
NOTE: 1. May be claimed for termination of viable or non-viable pregnancy.
2. May only be claimed when performed in an active treatment hospital or by a physician approved to perform the procedure by the CPSA when performed in an accredited non-hospital surgical
facility.

Sunday, March 1, 2020

UPDATE: Alberta abortion statistics for 2015/2016 to 2018/2019

UPDATE March 4, 2020 Claim codes for Alberta.

UPDATE March 3, 2020
My question to AHS regarding their statistics, and their response: 
Q. Can you explain why your stats are consistently lower than those stats reported by CIHI?
A. There are two reasons
1.       Difference in Data source (We use Claims and CIHI uses inpatient/outpatient data).
2.       Difference in methodology (We restrict any claims with 60 days as one abortion) but am not sure about CIHI (You can confirm with them).

I received abortion statistics from Alberta Health Services (AHS) through a freedom of information request. I then compared these numbers to CIHI's numbers. As you can see, AHS's numbers are less than CIHI's. This was a surprise since both Quebec and Ontario's numbers are higher than CIHI's.

But notice the footnotes.

From CIHI data:
"patients with coverage under Quebec’s health insurance plan receiving care in Alberta are reported by Alberta. However, patients with coverage under Alberta’s health insurance plan receiving care in Quebec are not reported (by either Quebec or Alberta)."
So abortions covered by AHS, but done in Quebec, aren't reported anywhere.

From Alberta data:
"Mifegymiso prescriptions were introduced in July 2017 which affected abortions numbers for the last two fiscal years."
So abortions covered by AHS do not include medical abortions, but only surgical abortions. This means that 2017/2018 and 2018/2019 numbers would be higher than reported--if only we knew how many medical abortions were occurring in Alberta.

Once again we have confusion over abortion statistics.