Showing posts with label medical abortions. Show all posts
Showing posts with label medical abortions. Show all posts

Wednesday, March 29, 2023

Part 1 - CIHI 2021 abortion data

CIHI is out with their 2021 abortion numbers. They are now adjusting their numbers to use doctor's billing codes. That is good. But what is bad is that they are not including all of their previous stats.

"March 23, 2023 — Provision of abortion services in Canada has evolved in recent years. Since the medical abortion medication Mifegymiso became available in Canada in 2017, medical abortions have become increasingly accessible in non-hospital settings (e.g., nurse practitioner and physician offices, community and public health clinics). In addition, the ongoing COVID-19 pandemic may have further shifted abortion services to non-hospital settings. As a result, reporting from traditional hospital data sources has led to an underestimation of the true number of induced abortions in Canada."

There are a lot of caveats to the 2021 data:

"Reporting enhancements

As part of CIHI’s ongoing improvement efforts, we explored opportunities to address data gaps, resulting in a revised methodology for reporting induced abortions for some jurisdictions in Canada. The methodology now includes physician billing data as the source of total abortion volumes and method of abortion for some provinces. 

Because of the revised methodology, 2021 results are not comparable with historical data results. Restated 2020 abortion volumes using the revised methodology can be found in the notes to Table 1. The tables also contain information regarding data sources and coding methodology.

Frequently asked questions

Why is the total number of reported induced abortions larger than in previous years?

The number has increased due to changes in reporting methodology. More complete reporting for 5 provinces (Newfoundland and Labrador, Nova Scotia, Ontario, Manitoba and British Columbia) is now sourced from physician billing data. Restated 2020 abortion volumes using the revised methodology can be found in the notes to Table 1.

Why were the reporting changes made now?

We enhanced the methodology as part of our ongoing efforts to improve completeness of reporting. The revised methodology better captures induced abortions, which are increasingly occurring in non-hospital settings (e.g., nurse practitioner and physician offices, community and public health clinics).

Why is the revised methodology used for some provinces only?

Due to variations in physician billing data capture and completeness across the country, it was not feasible to use the revised methodology for all jurisdictions; this has resulted in some ongoing underestimation of total abortion volumes. More comprehensive reporting may be available in future CIHI releases.

Do the results include the number of induced abortions from RU-486/mifepristone/Mifegymiso? 

Reported volumes include abortions induced by Mifegymiso that occurred in a hospital, that were reported voluntarily by clinics or that were captured in the medical abortion physician billing codes. The data does not permit us to report these volumes separately because there is no unique code to identify Mifegymiso in the data sources. A high-level breakdown by method of abortion can be found in Table 3.

Why are there fewer data tables in the 2021 data release compared with previous years?

Breakdowns derived from hospitalization data only are no longer included since they are not representative of all abortions across all settings and represent only a small proportion of the total number of abortions."

So you can see that there is a lot of missing information from previous years:

  • By Gestational age
  • By number of previous deliveries
  • By Number of previous abortions
  • By complications

I had to do a fair amount of diddling with the report to get it to print properly, (formatting, etc) and haven't had time yet to review the actual data yet. 

Wednesday, October 5, 2022

Sibling abortions, medical abortions, abortions > 14 weeks

I asked for, and received, abortion data for four Ontario regions: Hamilton, Ottawa, Peel and Toronto, for three years: 2019, 2020 and 2021. The data is for both hospitals and non-hospital settings. It is broken down by year within each city, and by abortion code.

While every abortion is a tragic reality, I am always struck by the particular evil of fetal reduction abortions (code P054). How does anyone even decide to do this? You have two children growing inside your womb, and you make the decision to kill one of them. How do you decide which child to kill? When the remaining alive child grows up, do you tell her that you killed her sister? Fetal reduction abortions:

  • There were 36 of these sibling abortions in Ottawa during these three years.
  • There were 401 of these sibling abortions in Toronto during these three years.

Then there are the > 14 weeks gestation abortions (code S785):

  • Hamilton performed 462 of these abortions during these three years.
  • Ottawa performed 598 of these abortions during these three years.
  • Peel performed 217 of these abortions during these three years.
  • Toronto performed 3,122 of these abortions during these three years.

Medical abortions seem to be increasing every year (Code A920). I guess this should not be a surprise:

  • Hamilton performed 2,497, 2,985, and 3,200 for each year = 8,682
  • Ottawa performed 1,667, 1,745, and 1,781 for each year = 5,193
  • Peel performed 621, 2,265, 3,644 for each year = 6,530
  • Toronto performed 8,035, 7,635 and 7,660 for each year - 23,330

S752 - induced - by any surgical technique up to and including 14 weeks gestation 
S785 - induced - by any surgical technique after 14 weeks of gestation
A920A - MEDICAL MANAGEMENT OF EARLY PREGNANCY - INITIAL VISIT (medical abortions)
P001A - MEDICAL MGMT FETAL DEMISE BETWEEN 14-20 WKS GESTATION
P054A - selective fetal reduction of one or more fetuses by intracardiac potassium chloride injection
S770A - CORPUS UTERI - HYSTEROTOMY.
S783A - CORPUS UTERI - HYSTEROTOMY WITH TUBAL INTERRUPTION.

Tuesday, June 28, 2022

CIHI 2020 abortion data: tragedy and confusion still reign

CIHI's 2020 abortion stats:

"volumes reported underestimate the true number of induced abortions in Canada"

There are so many caveats (bolded below) in CIHI's abortion data, that it truly is difficult to know how many abortions are being perpetrated in Canada.

From Page 2:

"CIHI captures administrative, clinical and demographic data on induced abortions performed in Canadian hospitals. Data is supplied by provincial and territorial ministries of health, hospitals, independent abortion specific clinics and other clinics in Canada. Data from clinics providing abortion services is submitted voluntarily to CIHI and most does not include information on abortion procedure or patient characteristics. Counts in the following tables include induced abortions performed in a hospital or in a clinic providing abortion services in Canada. Due to variations in use of fee-for-service (FFS) payments for induced abortions across the country, these figures are not based on pan-Canadian FFS data [this is why I like to make FOI requests for data: it is typically more accurate than CIHI's numbers]

In recent years, medical abortions have become more accessible in primary care settings (e.g., nurse practitioner and physician offices, community and public health clinics), and most of these are not included in the data tables. In addition, the COVID-19 pandemic has had an impact on hospital activity in Canada (e.g., delayed or cancelled surgeries). Measures to maintain early access to abortion services during the pandemic (e.g., virtual visits, extending gestational age limit for medical abortion) may have further shifted abortion volumes to primary care settings. Therefore, volumes reported underestimate the true number of induced abortions in Canada. More comprehensive reporting may be available in future CIHI releases.

Results presented in tables 3 to 8 are derived from hospitalization data only. Findings therefore exclude many early, medical and uncomplicated induced abortions, which occur more frequently in clinic and primary care settings. These results are unlikely to be representative of all abortions across all settings and may overestimate the proportion of all abortions with complications and underestimate the proportion of all abortions provided medically and in the first trimester."

And this note on Table 1:

"Number of induced abortions reported in Canada in 2020, by province/territory of hospital or clinic" (note: some abortions not included, for example, most medical abortions in primary care settings*)

And regarding Quebec's numbers:

The methodology for Quebec was revised in 2019 to include fee codes for medical abortions, resulting in an increase in reported abortion volumes for both hospitals and clinics.

So it seems most provinces do not report medical abortions to CIHI--but Quebec does report medical abortions?

Every abortion is a tragedy, but some are more tragic than others:

  • At least 1,376 women have had 2 or more hospital abortions (this number would be higher, because they exclude Quebec and clinic abortions)
  • At least 652 women have had hospital abortions at 21+ weeks gestation (this number would also be higher, because they exclude Quebec and clinic abortions)
  • 1,514 girls <=17 years old had an abortion. These girls cannot vote, legally drink or smoke dope, but they can abort their child.
How can we let this happen?

Tuesday, January 4, 2022

Quebec (gestational age and medical) abortions

In 2019 there were 538 medical abortions in Quebec. We also now have some gestational ages for Quebec abortions. 

CIHI doesn't report medical abortions, or gestational age abortions for Quebec.


Below is a breakdown of the types of abortions. My last Quebec stats.

Translation of codes below.


Gestational ages of Quebec abortions compared to the rest of Canada's (according to CIHI):



(English translation of abortion codes)

06137 - Gynecology / Uterus and cervix / Manipulation / Abortion by dilation and extraction from 20 weeks of pregnancy, including cervical expansion and laminar rod insertion (PG-28)

06451 - Gynecology / Tubes / Suture / Sterilization, any method, any route of approach, unilateral or bilateral, postpartum or elective, with or without curettage / with therapeutic abortion

06906 - Gynecology / Uterus and cervix / Manipulation / Incomplete abortion / by curettage

06908 - Gynecology / Uterus and cervix / Manipulation / Abortion / by menstrual extraction (including cervical dilation, insertion of laminar rods)

06909 - Gynecology / Uterus and cervix / Manipulation / Abortion / curettage (including cervical dilation, laminar rod insertion) (PG-28)

06941 - Gynecology / Uterus and cervix / Manipulation / Therapeutic abortion from 14 weeks / One time: (including the block paracervical, cervical dilation, insertion of laminar rods) / aspiration, curettage and evacuation of the fetus (P.G. 2.4.7.7 C) (P.C. 13)

06948 - Gynecology / Uterus and cervix / Manipulation / Abortion from 14 weeks / Two times: / 1st time: induction, all methods including, if necessary, the evacuation of the fetus (P.G. 2.4.7.7 C)

06949 - Gynecology / Uterus and cervix / Manipulation / Abortion from the 14th to the 19th week of pregnancy inclusively / 2nd time: curettage or spontaneous expulsion (PG-28)

Thursday, December 3, 2020

Ontario abortion rates are going up

Ontario abortion rates as reported by the Ontario Ministry of Long-Term Care are going up. Yet CIHI shows a decrease in Ontario abortion rates. So I'm not sure why CIHI keeps reporting Ontario numbers. In any event, since the MOHLTC's numbers are based on doctor's billing records, they intuitively should be more accurate.

You can see from the chart that overall, MOHLTC's numbers went down for three years in a row (2014/2015 to 2017/2017), but then for the next three years (2017/2018 to 2019/2020), they went up.

This disturbing trend upwards is most likely due to the abortion pill which became legal in 2017. This is really bad news for Canadians, especially those still in the womb.

Previous recent posts on abortion statistics:

Ontario out of province abortions for 2017

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

Ontario abortion numbers 2017/2018 

UPDATE The facts about abortions statistics in Canada

Monday, November 9, 2020

Abortions performed in the Northwest Territories

Below are the abortions being done in the Northwest Territories, with a comparison to what CIHI reports. Notice that CIHI reports slightly more than the NWT. Also note that the NWT is not reporting medical abortions. So actual numbers will definitely be higher than NWT is reporting.

Thursday, October 22, 2020

Canadian medical abortion numbers

Below find my chart of abortion totals for CIHI for 2018. I have added a 6th column to identify if a province publishes medical abortions. These medical abortion numbers are for early medical abortions and do not include the morning after pill.

Here is a link to a page that will allow you to access the individual provinces and their numbers. These numbers are all from Freedom of Information (FOI) requests I made to the individual provinces and territories.

I understand that medical abortions are not published in Canada anywhere else. If I am wrong about that please let me know.

Also note that CIHI does not report medical abortions.


Sunday, July 19, 2020

Yukon abortion statistics 66% higher than reported by CIHI

CIHI is reporting less abortions than Yukon Health and Social Services. Probably two reasons for this:
1) CIHI doesn't report physician office/clinic's abortions and
2) CIHI doesn't report medical abortions.
Notice that in 2018 the Yukon performed 66% more abortions than reported by CIHI. In 2018 there were 48 medical abortions, and in 2019 there were 49 medical abortions as reported by Yukon Health.

The trend for medical abortions will just keep increasing. Very bad news for children in the womb.

Friday, June 26, 2020

Gaining insight into New Brunswick's abortion statistics

By Peter Ryan

(Peter Ryan was Executive Director of New Brunswick Right to Life from 1999 to 2016. He recently published his Memoir The God of Life Lives: A Memoir)

The following is an attempt to shed insight into New Brunswick abortion statistics for 2015-19, as compiled by Patricia Maloney.

Ever since the advent of legalized abortion in Canada in 1969, abortion has been anything but a settled issue in New Brunswick. In the early 2000’s, for instance, two of the main hospitals (in Moncton, Fredericton) stopped doing abortions. A third major hospital (Saint John) did few or no abortions for decades. On the other hand, two formerly Catholic hospitals (Bathurst and Francophone hospital in Moncton) began doing abortions.

These instances of institutional aversion to or acceptance of abortion reflected the drama of decisions by individual obstetrician-gynecologists at the different locations. They also reflected New Brunswick’s unusual and, in comparison to most provinces, more restrictive policy: Until 2015, Medicare only covered abortions if they were performed in a hospital by an obstetrician-gynecologist after being certified by two physicians as medically necessary.

That policy became a major issue in the 2014 provincial election. The victorious Liberal party under Brian Gallant campaigned on removing abortion barriers. In 2015 the rules requiring two doctor approval and an ob-gyn were annulled.

Interestingly, the in-a-hospital requirement remained. As a result, the private abortion clinic that has operated in Fredericton since 1994 (first by Henry Morgentaler, then since 2015 by a different owner) is the only one in Canada not publicly funded.

Statistically, the profile for many years – before 2015 - was that about 1,000 surgical abortions a year took place in the province: about 400 in hospitals, and about 600 in the private clinic. This meant an abortion rate of about 13-14 abortions per 100 live births, less than half the Canadian average.

In my judgment New Brunswick’s reduced abortion rate, more restrictive Medicare policy, and exclusion of funding for private clinics reflect a more pro-life social and political culture than elsewhere. That culture was likewise expressed for a number of years when one-third or more of the sitting Members of the Legislature, and coming from both of the main parties (Liberals and Conservatives) attended the annual March for Life in Fredericton.

The ground shifted in 2015, with newly elected premier Brian Gallant touting abortion as a “Charter right,” though it is not. Under government auspices, a new abortion “service” was soon opened at The Moncton Hospital. A provincial hotline was also set up to give women “access” at hospital sites.

Three hospitals were publicly identified as offering abortions: beside The Moncton Hospital, the Dumont Hospital in Moncton (serving Francophones), and the Chaleur in Bathurst. What was not publicly disclosed, and has just now come to light, was that, starting in 2015, the province's other five regional hospitals also began to perform a small number of abortions each year.

Predictably, hospital surgical abortions rose significantly in 2015, 2016 and 2017 according to provincial government figures: 560, 608 and 656, respectively. (1) An average increase of over 50% compared to the 400 per year previously.

The increase for 2015-17 is even greater according to Canadian Institute for Health Information stats: an average of 734 per year, an increase of over 84% from pre-2015 years.

I have no explanation for the discrepancy between NB’s health department stats and those of CIHI. One thing is clear: Public policy changes after the 2014 election had a dramatic impact on the loss of prenatal lives.

As one examines the stats for individual hospitals, one is struck by how The Moncton Hospital has become the dominant center for surgical abortions, with an average of 292 abortions a year from 2016-19.

In 2017 a new phenomenon emerged: “medical abortions,” referring to chemical or mifegymiso (containing RU-486) abortions. That year New Brunswick became the first province to offer free chemical abortions. The government reported 162 in 2017. (2)

Chemical abortion stats then surged hugely in 2018 and 2019: 520 and 704, respectively. At the same time, surgical abortions decreased to 522 and 405, respectively. (3)

What is so dismaying for pro-lifers is that the net total number of Medicare-funded abortions has, during the past two years, reached an annual average of 1,075, more than two and a half times the pre-2015 average.

To give an accurate provincial picture, we must also factor in surgical abortions at the private clinic in Fredericton. While no public stats are available, Clinic 554 says they performed about 1,000 from 2015-19, or about 200 a year. Assuming that information is correct, it would mean a total of about 1,275 NB abortions a year as of 2018 and 2019.

Consequently, comparing the 2018-19 average to the pre-2015 average of about 1,000 abortions, we find the annual provincial total has increased by about 28%. The provincial population increased by less than 4% between 2015 and 2019. This means the lives of preborn children in New Brunswick have become significantly more at risk.

The NB abortion stats compiled for 2015-19 reveal one more newsworthy fact. The provincial government data includes gestational ages of abortions at five of the 8 main hospitals. What is striking is that, from 2015-18, the hospitals in Saint John and Fredericton (Chalmers) seemed to take turns specializing in second trimester abortions, whereas the other three hosptials listed did first-trimester procedures.

In 2015 and 2018 Saint John did a total of 14 abortions at an average age of 16.8 weeks; in 2016 and 2017 Fredericton did a total of 20 at an average age of 16.3. Whereas at the other three hospitals the average age for 2015-18 was 9.3 weeks.

The significantly higher average fetal age of abortions at two previously undisclosed locations is startling in light of complaints repeatedly made in recent years by abortion rights activists that Medicare-funded abortions were not available in hospitals at 14 weeks or more gestation, whereas, they argued, Clinic 554 did them up to 16 weeks but women were forced to pay. The newly published data reveal that, in truth, the hospital system had, since 2015 and without general public knowledge, acquiesced to those complaints, performing abortions up to and past 16 weeks.

Elected in 2018, the government of Blaine Higgs has stood firm against funding the private abortion clinic in Fredericton, despite pressure from the federal government. That pressure has included the withholding of $140,000 in health transfer funds due to NB’s policy.

The abortion situation in New Brunswick continues to be unsettled. In late 2019 Clinic 554 announced that due to lack of public funding they will be forced to close down. The building was put up for sale, though its operations continue in the meantime. How a closure would affect the profile of future hospital abortions remains to be seen.

The safety of preborn babies in New Brunswick has much deteriorated since 2014, reflected in markedly higher abortion numbers. The fact that all eight main hospitals have become involved in abortion, as opposed to two previously, is alarming.

What is especially shocking is how the number of “medical” (chemical) abortions has spiked, even after a new government not known for friendliness to abortion rights took office. Pro-lifers have always tended to focus greatly on the problem of surgical abortions. In the future more attention deserves to be given to chemical abortions, while not ignoring the plight of any preborn child.

On a positive note, New Brunswick’s life-friendly social culture has not greatly eroded. A poll by Narrative Research in February, 2020 found that two-thirds of residents oppose tax-funded abortion on demand.

(1) These totals do no include cases where a hospital performed 5 or fewer abortions.

(2) The government says mifegymiso is for pregnancies up to 7 weeks.

(3) That figure refers to government data; CIHI stats are not yet available for both of those years.

Wednesday, June 10, 2020

Nova Scotia's abortion numbers higher than CIHI

Nova Scotia's abortion numbers for 2015-2019 from Nova Scotia Health and Wellness.

Along with higher numbers reported using doctor's billing records than CIH reports, it also looks like Nova Scotia's abortion numbers are going up with the use of medical abortions. See jump in 2019.



Wednesday, May 6, 2020

Saskatchewan abortion statistics

Saskatchewan Ministry of Health abortion statistics are once again, different from what CIHI reports.

Also note that after October 1, 2018, the numbers reported by the Ministry of Health do not include medical abortions.


CIHI numbers for Saskatchewan:

2015 - 1,885
2016 - 2,082
2017 - 2,083
2018 - 2,009

Monday, April 20, 2020

BC abortion numbers vary from CIHI numbers

I've received total numbers of abortions from British Columbia Health for the past five years.

The first chart below has these totals, together with CIHI's totals. You can see that from 2015 to 2017, BC's totals are less than CIHI's totals. In 2014 and 2018, BC's totals are more than CIHI's totals.

The second chart gives additional surcharge services for two of the codes. So I did not include those services into the totals.

BC does include medical abortions. These numbers go up every year.


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.

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.

Monday, February 24, 2020

UPDATE The facts about abortions statistics in Canada

(UPDATE March 22, 2010. Quebec Health (RAMQ) has confirmed that their abortion numbers do not include medical abortions.)

The media has it wrong: New data suggests Canadian clinics and hospitals performing fewer abortionsSo does Joyce Arthur.

Why? Because what people always report are CIHI's numbers. And CIHI is missing a lot of data based on freedom of information requests I've done.

It is a well known fact CIHI under reports abortion numbers because they do not collect data based on fee for service records (i.e. OHIP billings in Ontario).
"CIHI captures administrative, clinical and demographic data on induced abortions performed in Canadian hospitals. Data is supplied by provincial and territorial ministries of health, hospitals and independent abortion clinics in Canada. Clinic data is submitted voluntarily to CIHI. Counts in the following tables include induced abortions performed in a hospital or clinic setting in Canada. Due to variations in use of fee-for-service (FFS) payments for induced abortions across the country, these figures are not based on pan-Canadian FFS data."
What we do know about CIHI's data:
  • abortions performed in physician's office are not reported (only hospitals and clinics are reported). (UPDATE March 2, 2020 Correction: CIHI apparently does a calculation to increase their accuracy  *** However they are still under reporting see below)
  • clinic abortion data is under reported because of its voluntary nature
  • medical abortions (the abortion pill RU-486) are not reported (for the most part they are prescribed through physician offices)
  • CIHI hospital abortion data is accurate
  • the only accurate data available for all abortions comes from FFS or doctor's billing records (OHIP in Ontario RAMQ in Quebec)
I have received data from Ontario billing records over the years. Recently I received Quebec billing recordsBoth of these sources are fairly accurate because they are based on FFS records.

Ontario: In 2017/2018 MOHLTC reported 42,853 abortions compared to 2018 CIHI reported 29,513 abortions in Ontario. A difference of 13,340 unreported abortions.

(UPDATE March 2, 2020): in 2017/2018 MOHLTC reported 42,853 and in 2017 CIHI reported 35,587. In the calculation above I used CIHI's 2018 numbers instead of 2017 numbers. The confusion comes from the fact that CIHI reports a calendar year, and MOHLTC reports a fiscal year of April 1, 2017- March 31, 2018. So it makes more sense to compare MOHLTC numbers to CIHI's calendar year. Therefore Ontario: In 2017/2018 MOHLTC reported 42,853 abortions compared to 2017 CIHI who reported 35,587 abortions in Ontario. A difference of 7,266 unreported abortionsThis means CIHI under reported Ontario's abortions by 20.42%. I will be doing more comparisons in a later post.)

Quebec: Recently I reported numbers for the first time from Quebec

In 2018 RAMQ reported 26,979 compared to 22,093 from CIHI = 4,886 unreported abortions

This means CIHI under reported Quebec's abortions by 22%.

Quebec and Ontario are the largest provinces in Canada. Therefore they perform the most abortions. So total numbers of abortions reported by CIHI are probably somewhere between 22% and 45% lower than the actual totals.

CIHI reported 85,195 in 2018 for all of Canada. Quebec and Ontario abortions make up 65% of that number. If we assume all provinces have similar under reported abortion numbers, it's fair to say that the percentages would be somewhere between 22% or 45% higher than CIHI reports.

This means the total number of abortions done in Canada in 2018 can reasonably be expected to be somewhere between 103,937 to 123,532. Not 85,195.

UPDATE March 2, 2020 from CIHI: "The report you shared (42,853) includes seven fee codes, however CIHI reports only using two fee codes. If you limit your comparison to the 2 surgical fee codes (S752 and S785), the total numbers presented in the MOH report are very close to CIHI’s reported numbers (32,795 vs 29,513 respectively). In addition, CIHI reported for calendar year 2018 while the other report appears to be based on fiscal year 2017/18 data."

To which I responded: "So why doesn't CIHI use all the fee codes used by Ontario, since those are abortions as well? There is a big 45% difference between CIHI's numbers and Ontario's numbers. Ontario reported 42,853 and CIHI only reported 29,513. I realize there is a difference in the two reporting periods, because MOHLTC reports using a fiscal year, CIHI uses a calendar year, but there is no way to get a completely equivalent time frame, so I must compare the two years in this manner."


*** This is included on CIHI's annual reports on abortion ***

The methodology to estimate induced abortion volumes for Ontario is consistent with the enhanced methodology that was introduced in the 2015 report. Total volumes were derived by using the total abortion volumes reported to the National Physician Database (NPDB) at CIHI and adding both hospital-based abortions for non-Ontario residents and hospital-based medical-method-only abortions for Ontario residents (as reported to the Discharge Abstract Database and the National Ambulatory Care Reporting System). For Ontario, volumes reported in the column Number of induced abortions reported by clinics include services from non-hospital settings. Volumes for non-hospital settings (clinics/surgical facilities/physician offices) were estimated using the total abortion volumes as described above and subtracting hospital-based abortions. This methodology results in induced abortions occurring in physician offices and in clinics being included in non-hospital settings volumes. This estimation approach for non-hospital volumes was required because information on the location where the service is rendered (e.g., clinic, hospital, physician’s office) may not be included in the NPDB data.

Update March 3, 2020 from OMHLTC: 

"Health Services Branch has confirmed that medical abortions would be captured under A920A." This means that medical abortions are being captured under A920. But so are missed abortions. As well, there are other methods to deal with missed abortions which do not include RU486What a dog's breakfast abortion statistics are.

UPDATE March 4, 2020, comparison of Ontario and CIHI's data for the past four years.

Thursday, November 9, 2017

Health Canada ATIP on RU-486

Here is the information for an ATIP I made to Health Canada for the abortion drug RU-486.

There was one document for pages 345-2544. It is too large to be able to access from the Google drive. It appears to be 2000 pages of data, but impossible to decipher what the data means. It also seems to contain data other than misoprostol and mifepristone.

Pages 1-336
https://drive.google.com/file/d/0B_QDsYLWnwO6d1lWbDI3MXNNeVU/view?usp=sharing

Pages 337-344
https://drive.google.com/file/d/0B_QDsYLWnwO6MlItSm9Yd2lOeG8/view?usp=sharing

Pages 2545-2547
https://drive.google.com/file/d/0B_QDsYLWnwO6WDlielFDXzlQLTA/view?usp=sharing

Pages 2548-2968
https://drive.google.com/file/d/0B_QDsYLWnwO6azB5SnZqR2tIMU0/view?usp=sharing

Pages 2969-3050
https://drive.google.com/file/d/0B_QDsYLWnwO6U19VSzRIWkJpdnc/view?usp=sharing