Hospital care for cardiovascular disease

All cardiovascular disease

There were over 1.1 million hospitalisations where cardiovascular disease (CVD) was recorded as the principal and/or additional diagnosis in 2014–15, 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 2014–15 there were around:

  • 490,000 hospitalisations with CVD as the principal diagnosis (the diagnosis largely responsible for hospitalisation).
  • 657,000 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 (30% of CVD hospitalisations)
  • heart failure and cardiomyopathy (13%)
  • stroke (8%) and
  • peripheral vascular disease (6%) (Figure 1).

Figure 1: Major causes of hospitalisation for CVD (principal diagnosis), by sex, 2014–15

The horizontal bar chart shows that coronary heart disease was the leading condition where the principal diagnosis was CVD — 99,584 for males and 46,378 for females. This was followed by heart failure and cardiomyopathy (33,647 for males and 28,610 for females) and stroke (20,395 for males and 17,846 for females). Males had a higher number of hospitalisations than females across all leading conditions except hypertensive disease and rheumatic heart disease.

Source: AIHW National Hospital Morbidity Database (Data source table).

Trends

The number of hospitalisations for CVD as the principal diagnosis increased by 7% between 2005–06 and 2014–15, from 459,000 to 490,000 hospitalisations. Despite increases in the number of hospitalisations, the age-standardised rates have declined by 15% over this period, from 2,153 to 1,823 per 100,000 population. The rate of CVD hospitalisations among males was consistently higher than that for females over the period, with both showing similar trends (Figure 2).

Figure 2: Trends in CVD hospitalisations (principal diagnosis), by sex, 2005–06 to 2014–15

The line chart shows that CVD hospitalisation rates (as a principal diagnosis) have declined steadily between 2005–06 and 2014–15 by around 16%25—from 2,272 to 2,679 events per 100,000 for males and 1,415 to 1,686 per 100,000 population for females. The CVD hospitalisation rates for males have been consistently higher than for females.

Note: Age–standardised to the 2001 Australian Standard Population.

Source: AIHW National Hospital Morbidity Database (Data source table).

Age and sex

In 2014–15, CVD hospitalisation rates (as the principal diagnosis):

  • Were overall 1.6 times as high for males than females (2,272 and 1,415 per 100,000 population). Age-specific rates were higher among males than females across all age groups (Figure 3).
  • Increased with age, with over four in five (82%) 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 (19,100 and 14,498 per 100,000 population, respectively)—at least 1.4 times as high as those in the 75–84 age group (13,673 and 9,346 per 100,000) (Figure 3).

Figure 3: CVD hospitalisations (principal diagnosis), by age and sex, 2014–15

The vertical bar chart shows that CVD hospitalisations rates (as the principal diagnosis) in 2014–15 increased steadily with age, and were consistently higher in males than females. The difference in rates between males and females is largest in those aged 55–64 (twice as high in males or 4,165 and 2,026 per 100,000 males and females respectively) (Figure 3).

 

Source: AIHW National Hospital Morbidity Database (Data source table).

Inequalities

In 2012–13, CVD hospitalisation rates (as the principal and/or additional diagnosis) increased with remoteness and socioeconomic disadvantage.

  • Around 30% higher in Remote and very remote areas compared with Major cities. This pattern was largely driven by the rate for females―5,848 compared with 4,001 per 100,000 population, respectively―while for males rates were similar between these areas of Australia (6,040 compared with 5,336 per 100,000) (Figure 4).
  • 24% higher for those in the lowest socioeconomic group compared with the highest socioeconomic group (based on area of usual residence)—5,246 compared with 4,215 per 100,000. This gap was similar for males and females (Figure 4).

Figure 4: CVD hospitalisations (principal and/or additional diagnosis), by remoteness and socioeconomic group, 2012–13

The horizontal bar chart shows that in 2012–13, CVD hospitalisation rates were highest in remote and very remote areas compared with other areas of Australia for both males and females. Males had consistently higher rates than females across most areas. CVD hospitalisation rates (as a principal and/or additional diagnosis) increased with socioeconomic disadvantage —for males from 4,864 per 100,000 in the lowest socioeconomic group (group 1) to 6,027 per 100,000 in the highest socioeconomic group (group 5). For females the corresponding rates were 3,669 and 4,554 per 100,000, respectively.

Note: Age-standardised to the 2001 Australian Standard Population.

Source: AIHW National Hospital Morbidity Database (Data source table).

Aboriginal and Torres Strait Islander people

In 2013–14, there were around 11,900 hospitalisations for CVD (as the principal diagnosis) among Aboriginal and Torres Strait Islander people, a rate of 3,149 per 100,000 population.

  • The rate among Indigenous Australians was overall almost twice as high as the non-Indigenous rate (3,149 and 1,771 per 100,000).
  • The disparity between Indigenous Australians and non-Indigenous Australians was greater for females than males—2.1 times as high for females (2,824 compared with 1,368 per 100,000) and 1.6 times as high for males (3,519 compared with 2,215 per 100,000).

Coronary heart disease (CHD)

There were over 224,000 hospitalisations where CHD was recorded as the principal or additional diagnosis in 2014–15. This represents 2% of all hospitalisations in Australia.

Two-thirds (146,000) of CHD hospitalisations were recorded as the principal diagnosis.

Where CHD was the principal diagnosis, hospitalisation rates:

  • Were overall 2.4 times as high for males than 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 (4,276 per 100,000 population) and females 85 years and over (2,571 per 100,000) (Figure 5).

Figure 5: CHD hospitalisations (principal diagnosis), by age and sex, 2014–15

The vertical bar chart shows that CHD hospitalisation rates (as the principal diagnosis) increased rapidly with age for both males and females in 2014–15, with rates highest among males aged 75–84 years (4,276 per 100,000 population) and females 85 years and over (2,571 per 100,000 population). CHD hospitalisation rates were consistently higher among males than females.

Source: AIHW National Hospital Morbidity Database (Data source table).

Heart failure and cardiomyopathy

There were over 167,000 hospitalisations where heart failure and cardiomyopathy was recorded as the principal or additional diagnosis in 2014–15. This represents 1.6% of all hospitalisations in Australia.

Almost 40% of hospitalisations (62,300) 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 overall 1.5 times as high for males than females. Age-specific rates were higher among males than females from age 25 years (Figure 6).
  • Increased with age, with rates highest for males and females in the 85 and over age group (5,327 and 4,014 per 100,000 population)―at least 2.4 times as high as those in the 75–84 age group (2,227 and 1,531 per 100,000) (Figure 6).

Figure 6: Heart failure and cardiomyopathy hospitalisations (principal diagnosis), by age and sex, 2014–15

The vertical bar chart shows that heart failure and cardiomyopathy hospitalisation rates (as the principal diagnosis) increased rapidly with age from age 65 years and over for both males and females, and were highest among those aged 85 and over—5,327 for males and 4,014 for females per 100,000 population in 2014–15.

Source: AIHW National Hospital Morbidity Database (Data source table).

Stroke

There were over 71,000 hospitalisations where stroke was recorded as the principal or additional diagnosis in 2014–15. This represents 0.7% of all hospitalisations in Australia.

Over half (38,000) of hospitalisations for stroke were recorded as the principal diagnosis.

Where stroke was recorded as the principal diagnosis, hospitalisation rates:

  • Were overall 1.4 as high for males than 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 (2,121 and 1,871 per 100,000 population)―around twice as high as those in the 75–84 age group (1,195 and 897 per 100,000) (Figure 7).

Figure 7: Stroke hospitalisations (principal diagnosis), by age and sex, 2014–15

The vertical bar chart shows that in 2014–15, stroke hospitalisation rates (as a principal diagnosis) increased rapidly with age from age 65 and over, with rates twice as high in the 85 and over age group (2,121 and 1,871 per 100,000 males and females) compared with the 75–84 age group (1,195 and 897 per 100,000 males and females).

Source: AIHW National Hospital Morbidity Database (Data source table).

Hospital procedures for CVD

Procedures are provided in hospitals to admitted patients to diagnose or treat CVD. The table below shows the most common procedures provided in hospital, sourced from the AIHW National Hospital Morbidity Database.

In 2014–15, the most common procedures performed in hospital were coronary angiography (128,000), percutaneous coronary intervention (39,800), echocardiography (36,100), and pacemaker insertion (15,900). The number of procedures to diagnose and treat CVD was higher among males than females (Data source table).