Hospital care for cardiovascular disease

All cardiovascular disease (CVD)

There were almost 1.2 million hospitalisations where CVD was recorded as the principal and/or additional diagnosis in 2016–17, according to the AIHW National Hospital Morbidity Database. This represents 11% of all hospitalisations in Australia. Note that hospitalisation data presented here are based on admitted patient episodes of care, including multiple events experienced by the same individual.

In 2016–17 there were around:

  • 576,500 hospitalisations with CVD as the principal diagnosis (the diagnosis largely responsible for hospitalisation).
  • 615,800 hospitalisations with CVD as an additional diagnosis (a coexisting condition with the principal diagnosis or a condition arising during hospitalisation that affects patient management).

When CVD was listed as the principal diagnosis, the leading conditions were:

  • coronary heart disease (28% of CVD hospitalisations)
  • heart failure and cardiomyopathy (12%)
  • stroke (11%) and
  • peripheral vascular disease (6%) (Figure 1).

Figure 1: Major causes of hospitalisation for CVD (principal diagnosis), by sex, 2016–17

This bar graph shows that the most common major cause of CVD hospitalisations was coronary heart disease, followed by heart failure and cardiomyopathy, stroke, peripheral vascular disease.

Chart: AIHW. Source: AIHW analysis of the National Hospital Morbidity Database. (Data table)

Trends

The number of acute hospitalisations for CVD as the principal diagnosis increased by 32% between 2000–01 and 2016–17, from 391,400 to 518,000 hospitalisations. Despite increases in the number of hospitalisations, the age-standardised rate for acute care declined by 14% over this period, from 2,100 to 1,800 per 100,000 population. The rate of CVD hospitalisations among males was higher than that for females across the period (Figure 2).

Figure 2: Rate of hospitalisations for acute care for CVD (principal diagnosis), by sex, 2000–01 to 2016–17

This line graph shows that the age-standardised rate of acute care hospitalisations for CVD has declined between 2000–01 and 2015–16 for both males and females.  Males consistently had a higher age-standardised rate of acute care hospitalisations for CVD (2,261 hospitalisation per 100,000 in 2016–17) than females (1,390 hospitalisation per 100,000 in 2016–17).

Note: Age-standardised to the 2001 Australian Standard Population.
Chart: AIHW. Source: AIHW analysis of the National Hospital Morbidity Database. (Data table)

Age and sex

In 2016–17, CVD hospitalisation rates (as the principal diagnosis):

  • Were 1.6 times as high for males as females (2,300 and 1,400 per 100,000 population) after adjusting for age. Age-specific rates were higher among males than females across all age groups (Figure 3).
  • Increased with age, with over four in five (83%) CVD hospitalisations occurring in those aged 55 years and over. CVD hospitalisation rates for males and females were highest in the 85 years and over age group (21,400 and 16,400 per 100,000 population, respectively)—1.4 times as high as those in the 75–84 age group for males and 1.6 times as high among females (15,400 and 10,500 per 100,000, respectively) (Figure 3).

Figure 3: CVD hospitalisations (principal diagnosis), by age and sex, 2016–17

This column graph shows that the rate of CVD deaths increased with age, with the highest rate for both males and females in those aged 85 year and over (4,830 and 4,655 per 100,000 population, respectively).

Chart: AIHW. Source: AIHW analysis of the National Hospital Morbidity Database. (Data table)

Variation among population groups

In 2016–17, CVD hospitalisation rates (as the principal diagnosis) increased with remoteness and socioeconomic disadvantage.

  • Around 35% higher in Remote and very remote areas compared with Major cities. This pattern was largely driven by the rate for females―2,300 compared with 1,600 per 100,000 population, respectively―while rates for males were more similar between these areas of Australia (3,000 compared with 2,500 per 100,000) (Figure 4).
  • 21% higher for those in the lowest socioeconomic group compared with the highest socioeconomic group—2,300 compared with 1,900 per 100,000. This gap was similar for males and females (Figure 4).

Figure 4: CVD hospitalisations (principal diagnosis), by remoteness and socioeconomic group, 2016–17

This bar graph shows the prevalence of self-reported heart, stroke and vascular disease, among adults did not vary significantly by remoteness area. However, the proportion of people who reported having heart, stroke and vascular disease was slightly higher among those living in the most disadvantaged areas compared to those in the least disadvantaged areas.

Note: Age-standardised to the 2001 Australian Standard Population.
Chart: AIHW. Source: AIHW analysis of the National Hospital Morbidity Database. (Data table)

Aboriginal and Torres Strait Islander people

In 2016–17, there were around 14,800 hospitalisations for CVD (as the principal diagnosis) among Aboriginal and Torres Strait Islander people, a crude rate of 2,000 per 100,000 population.

After adjusting for differences in the age structure of the populations:

  • The rate among Indigenous Australians was overall 1.8 times as high as the non-Indigenous rate.
  • The disparity between Indigenous Australians and non-Indigenous Australians was greater for females than males—2.2 times as high for females (3,400 compared with 1,500 per 100,000) and 1.5 times as high for males (3,700 compared with 2,500 per 100,000).

Coronary heart disease (CHD)

There were over 230,300 hospitalisations where CHD was recorded as the principal or additional diagnosis in 2016–17. This represents 2.1% of all hospitalisations in Australia.

Seventy percent (160,400) of CHD hospitalisations were recorded as the principal diagnosis.

Where CHD was the principal diagnosis, hospitalisation rates:

  • Were 2.5 times as high for males as for females. Age-specific rates were higher among males than females across all age groups (Figure 5).
  • Increased with age and were highest among males aged 75–84 years (4,600 per 100,000 population) and females 85 years and over (2,600 per 100,000) (Figure 5).

Figure 5: CHD hospitalisations (principal diagnosis), by age and sex, 2016–17

This column graph shows that the rate of CHD hospitalisations increased with age for women. For males, the rate of CHD hospitalisations increased with age, reaching a peak in those aged 75–84 years (4,622 per 100,000 population). Males had a higher rate of CHD hospitalisations than females across all age groups. Among people aged 85 and over, males had a rate of 4,285 CHD hospitalisations per 100,000 population, while females had a rate of 2,566 CHD hospitalisations per 100,000 population.

Chart: AIHW. Source: AIHW analysis of the National Hospital Morbidity Database. (Data table)

Heart failure and cardiomyopathy

There were around 178,300 hospitalisations where heart failure and cardiomyopathy was recorded as the principal or additional diagnosis in 2016–17. This represents 1.6% of all hospitalisations in Australia.

Almost 40% of hospitalisations (70,800) for heart failure and cardiomyopathy were recorded as the principal diagnosis.

Where heart failure and cardiomyopathy was recorded as the principal diagnosis, hospitalisation rates:

  • Were 1.5 times as high for males as females. Age-specific rates were higher among males than females in all age groups (Figure 6).
  • Increased with age, with rates highest for males and females in the 85 and over age group (5,900 and 4,500 per 100,000 population)―at least 2.5 times as high as those in the 75–84 age group (2,300 and 1,600 per 100,000) (Figure 6).

Figure 6: Heart failure and cardiomyopathy hospitalisations (principal diagnosis), by age and sex, 2016–17

This column graph shows that the heart failure and cardiomyopathy hospitalisation rate increased with age. Males had a higher heart failure and cardiomyopathy hospitalisation rate than females across all age groups.  For males, the hospitalisation rate increased from 4 hospitalisations per 100,000 population in those aged 25 and under, to 5,861 hospitalisations per 100,000 population in those aged 85 and older. For females, the hospitalisation rate increased from 3 hospitalisations per 100,000 population among those aged 25 and under, to 4,465 hospitalisations per 100,000 population in those aged 85 and older

Chart: AIHW. Source: AIHW analysis of the National Hospital Morbidity Database. (Data table)

Stroke

There were over 80,200 hospitalisations where stroke was recorded as the principal or additional diagnosis in 2016–17. This represents 0.7% of all hospitalisations in Australia. 81% (65,000) of hospitalisations for stroke were recorded as the principal diagnosis in 2016–17.

In 2016–17, where stroke was recorded as the principal diagnosis, hospitalisation rates:

  • Were 1.4 times as high for males as for females. Age-specific rates were higher among males than females from age 35 years (Figure 7).
  • Increased with age, with rates for males and females highest in the 85 and over age group (3,000 and 2,600 per 100,000 population)―around 1.6 times as high as those in the 75–84 age group among males (1,900 per 100,000) and 2 times as high among females (1,300 per 100,000) (Figure 7).

Figure 7: Stroke hospitalisations (principal diagnosis), by age and sex, 2016–17

This column graph shows that the stroke hospitalisation rate increased with age. The rate for males was higher than for females from the age of 35 years.  For males, the rate of stroke hospitalisations increased from 1,883 to 2,986 per 100,000 population between the age groups 75–84 years and 85 and over. For females, the rate of stroke hospitalisations increased from 1,338 to 2,649 per 100,000 population between the age groups 75–84 years and 85 and over.

Chart: AIHW. Source: analysis of the National Hospital Morbidity Database. (Data table)

Hospital procedures for CVD

Procedures are provided in hospitals to admitted patients to diagnose or treat CVD.

In 2016–17, the most common procedures performed in hospital were coronary angiography (133,900), percutaneous coronary intervention (43,300), echocardiography (41,500), and pacemaker insertion (17,200). The number of procedures to diagnose and treat CVD was higher among males than females.