Hospital to community: How Australians with heart failure receive health care

The first acute care hospitalisation with a diagnosis of heart failure in 2019 is referred to as the person’s index hospitalisation. 

At the index hospitalisation, 59% of the cohort had no prior hospitalisation with a diagnosis of heart failure identified in the dataset. Sixteen percent had a heart failure hospitalisation in the previous year. 

Heart failure was the principal diagnosis (the diagnosis largely responsible for hospitalisation) at the index hospitalisation for 41% of the cohort. The remaining 59% had heart failure recorded as an additional diagnosis. This means that heart failure was not primarily responsible for the admission but was a coexisting condition at the time of the hospitalisation, which most likely impacted treatment decisions or care. 

For proportion of index hospitalisations with each ICD-10AM diagnosis code, see table S2.1 in supplementary data tables. 

Among hospitalisations where heart failure was an additional diagnosis, the most common principal diagnoses were: 

• other chronic obstructive pulmonary disease (COPD) (10%)
• acute myocardial infarction (8.2%)
• atrial fibrillation and flutter (7.8%) 
• pneumonia (7.5%).

Procedures and investigations

Selected cardiovascular disease related procedures and investigations were identified at the cohort’s index hospitalisation. The most common procedure or investigation performed was coronary angiogram (12% of the cohort). 

Echocardiograms, percutaneous coronary intervention (PCI), coronary artery bypass graft surgery (CABG) and heart valve repair/replacement procedures were more common in hospitalisations where heart failure was an additional diagnosis, compared to hospitalisations with a principal diagnosis of heart failure. 

Length of stay

Twelve percent of index hospitalisations were the same day or a one-night stay. More than half (55%) were between 2 and 9 days in length, and 32% were 10 days or longer. For comparison, in 2022–23 the average length of stay was 2.7 days for all hospitalisations in Australia (AIHW, 2025).

Hospitalisations with a principal diagnosis of heart failure were more likely to be shorter than 5 days (51%) when compared to those with an additional diagnosis of heart failure only (32%, Figure 6).

Other health conditions at index hospitalisations

Selected other health conditions were identified at the index hospitalisation. It is important to note that not all health conditions a person had at the time of hospitalisation will be identified through the hospital data. 

Three in 5 (61%) people had a cardiovascular disease other than heart failure identified at the time of the index hospitalisation. This included 40% with a diagnosis of coronary heart disease and 25% with a diagnosis of atrial fibrillation or flutter (Figure 7). 

Commonly identified non-cardiovascular disease conditions included chronic kidney disease (33%), type 2 diabetes (35%), pneumonia (19%) and chronic obstructive pulmonary disease (COPD) (17%).  

Those with a prior heart failure hospitalisation were more likely to have a diagnosis of type 2 diabetes (41%), chronic kidney disease (43%) and kidney failure (24%) when compared to those with no prior heart failure admissions (type 2 diabetes: 30%, chronic kidney disease: 26%, kidney failure: 14%).

Variation by population group

Variation by population group was most common for selected non-cardiovascular disease (CVD) comorbidities identified during the index hospital stay (Figure 8). 

• First Nations people were more likely to have a diagnosis of type 2 diabetes (46% or 1,300 people), chronic kidney disease (36% or 1,000 people), chronic liver disease (9.6% or 275 people), and COPD (24% or 690 people) when compared to other Australians 
• People born overseas were more likely to have a diagnosis of type 2 diabetes (41% or 10,100 people) and chronic kidney disease (37% or 9,300 people) when compared to people born in Australia 
• People who lived in the lowest socioeconomic areas (most disadvantaged) were more likely to have a diagnosis of type 2 diabetes (39% or 8,500 people) and COPD (20% or 4,300 people) compared to people who lived in the least disadvantaged socioeconomic areas.