The ratio of the actual number of in-hospital deaths in a region or hospital to the number that would have been expected, based on the types of patients a region or hospital treats.

Observed deaths, or actual number of in-hospital deaths that occurred in a hospital or region.

Expected deaths, or number of deaths that would have occurred in a hospital or region had the mortality of these patients been the same as the mortality of similar patients across the country, based on the reference years (2018–2019 to 2020–2021).

Cadavers or stillborns (Discharge Disposition Code = 08 or 09, or Admission Category Code = R or S), records with most responsible diagnosis (MRDx) of palliative care (ICD-10-CA: Z51.5) or medical assistance in dying.

For each HSMR diagnosis group, the HSMR logistic regression models are fitted with age, sex, length-of-stay (LOS) group, admission category (urgent and elective), comorbidity (Charlson Index Score) group, transfers and COVID-19 as independent variables.

By reporting level: National, Province/Territory, Region, Facility.

Discharge Abstract Database (DAD), Human Metabolome Database (HMBD)

Online tool: Your Health System

www.cihi.ca/en/access-data-and-reports/indicator-library

www.cihi.ca/en/indicators/hospital-deaths-hsmr