Analysis of Statistical Area Level 3 (SA3) rates shows a nine-fold variation in hospitalisations for acute myocardial infarction (MI; heart attack) and a four-fold variation for hospitalisations for atrial fibrillation as a principal diagnosis.
In Australia, cardiovascular conditions are the leading cause of death and are responsible for 13% of hospitalisations. To address rates of cardiovascular hospitalisations, risk factors must be reduced through public health initiatives. System changes are needed to improve access to primary health care for high-risk groups, and primary and secondary prevention for individuals needs to improve. Increasing the health literacy of high-risk groups and their ability to self-manage risk factors is a vital component of any strategy to reduce hospitalisations due to cardiovascular diseases.
Hospitalisation rates for MI are 3 times higher among Aboriginal and Torres Strait Islander Australians than other Australians. Higher rates of hospitalisation for MI are also found in areas of socioeconomic disadvantage. Reducing smoking rates could decrease the number of hospitalisations for MI and atrial fibrillation significantly.
The original intent of this chapter was to examine patterns of use of many more investigations and therapies for cardiovascular disease. However, the available data would not have produced reliable results. For example, difficulties in tracking the care of patients transferred between hospitals meant that accurate pictures of variation in the use of interventions for MI could not be produced. Developing capabilities to use linked data will enable variation in care for patients with cardiac disease to be explored. Collecting more detailed data on cardiac care, ideally through a clinical quality registry, would enable more intensive analysis of treatments and outcomes, helping to guide future improvements in care. Routine review of benchmarked clinical performance and outcomes data through clinical quality registries could also improve cardiac care.
2a. State and territory health departments to examine variation in the timeliness and access of patients to appropriate investigations and interventions for suspected acute myocardial infarction.
2b. The Commission to develop a clinical care standard on the management of atrial fibrillation.
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