Study overview
Heart failure is a condition that has considerable impact on the health of Australians. The frequency of self-reported heart failure increased from 110,000 to 143,700 people between the 2017–18 and 2022 National Health Surveys (ABS 2023; ABS 2017-18). In 2022, heart failure and cardiomyopathy contributed to 15% of deaths in Australia and 1.5% of all hospitalisations in 2021–22 (AIHW 2024).
Effective health care in the community can help people with heart failure keep well and remain out of hospital for longer. Measures of mortality and readmissions among people hospitalised with heart failure are used as indicators of health system and hospital performance both in Australia and internationally (ACSQHC 2021; OCED 2023).
Data available in the National Health Data Hub (NHDH) allows the health care pathways of people hospitalised with heart failure in Australia to be explored. Through administrative data, it captures health services and medications people accessed after hospital discharge, readmission to hospital, residential aged care stays and mortality.
This project aims to describe the characteristics of people hospitalised with heart failure in Australia and illustrate their care in hospital and as they transition back into the community.
The key research questions this project explored are:
- What are the characteristics of people hospitalised with heart failure?
- What kinds of community-based care do people access following a heart failure related hospitalisation? Does care vary among population subgroups?
- What are the health outcomes of people in the one year following a heart failure hospitalisation?
Box 1. What is heart failure?
Heart failure occurs when the heart functions less effectively in pumping blood around the body. It can occur suddenly, although it usually develops slowly as the heart gradually becomes weaker. Heart failure can result from a variety of diseases and conditions that impair or overload the heart. These include heart attack, high blood pressure, damaged heart valves or cardiomyopathy.
Cardiomyopathy is where the entire heart muscle, or a large part of it, is weakened. Cardiomyopathy and heart failure commonly occur together. Selected cardiomyopathy codes have been included in the identification of the heart failure cohort as they are frequently associated with, or lead to, heart failure.
Data
This study used the National Health Data Hub (NHDH) version (NIHSI 3.0). The NHDH links de-identified, person-level data from hospitals and emergency departments, aged care facilities, the Medicare Benefits Schedule, the Pharmaceutical Benefits Scheme and Repatriation Pharmaceutical Benefits Scheme, the National Death Index and other data. The NHDH allows for person-centred analysis of health service use and health outcomes among those hospitalised with heart failure.
The NHDH was formerly the National Integrated Health Services Information (NIHSI) analytical asset. The NIHSI version 3.0 used for this study included hospital data from 2010–11 to 2020–21 from New South Wales, Victoria, Queensland, South Australia, Tasmania and the Australian Capital Territory. For most states, the admitted patient care data were limited to only public hospitals. Results may not be generalisable to Western Australia and the Northern Territory.
Further information
- For more details of the data used in this report, see Technical notes: Data source.
- Additional information about the National Health Data Hub can be found on the AIHW website.
Cohort
The cohort included 71,494 people who had a heart failure related hospitalisation in 2019. The cohort was limited to those who had an acute care type and were alive when discharged from hospital. In this report the first in-scope hospitalisation in 2019 for each person is referred to as their ‘index hospitalisation’.
Further information
For additional information, see Technical notes: cohort selection
Study periods
The study periods referred to in this report are illustrated in Figure 1. The cohort entry period of 2019 was chosen based on the availability of data for a one-year follow-up post index hospitalisation. For many in the cohort, the follow-up period will include a period in 2020 in which Australia’s population and health system was affected by the COVID-19 pandemic. For more information about how this may impact the results of the study, see Technical notes: limitations.
Figure 1: Study period
A timeline view of the study period including the start (1 July 2010), cohort entry start (1 January 2019) and end (31 December 2019), and end of 1 year follow up (31 December 2020).
Key terms used in the report
Below are selected key terms and concepts used in this report.
‘The cohort’ refers to the 71,494 people who had an acute care hospitalisation with a principal or additional diagnosis of heart failure and were alive when discharged from hospital. These people are drawn from the National Health Data Hub (NHDH), all were enrolled on Medicare and, at the time of their index hospitalisation, did not usually reside in Western Australia or the Northern Territory.
The first acute care hospitalisation with a diagnosis of heart failure in 2019 is referred to as the person’s index hospitalisation. The hospitalisation (or episode of care) may involve hospital transfers or changes in care type that form a continuous stay in hospital. For more information, see Technical notes: cohort selection.
Principal diagnosis: The diagnosis established to be chiefly responsible for occasioning an episode of admitted patient care.
Additional diagnosis: Conditions or complaints, either coexisting with the principal diagnosis or arising during the episode of admitted patient care (hospitalisation) that require the provision of care. Multiple diagnoses may be recorded.
Diagnoses are recorded using the relevant edition of the International Statistical Classification of Diseases and Related Health Problems, 10th revision, Australian modification (ICD-10-AM).
Any hospitalisation with a principal or additional diagnosis of heart failure between 1 July 2010 (start of the data set) and the index hospitalisation. It is important to note that hospitalisations from Western Australia and Northern Territory and some private hospitals are not captured in the NHDH.
The data in this report is based on hospital admissions records. Hospital records recorded patients' sex as 'male', 'female' or 'other'.
Depending on the practices of the hospital, this may be based on what the patient selected or how hospital staff completed the record. It may also be based on an existing hospital record for the patient, which may no longer reflect how they identify.
It is important to note that it is not known if the people completing these records interpreted sex to mean sex at birth or gender identity.
First Nations people included people who ever identified as Aboriginal or Torres Strait Islander in hospital (admitted patient care) data. This includes people who had other admitted patient care episodes that recorded the person as non-Indigenous, meaning it may overestimate the number of First Nations people in the cohort.
The comparison group, ‘other Australians’ includes people who only had admitted patient care episodes that recorded them as non-Indigenous or the field was left blank. For further information, see Technical notes: limitations.
Remoteness area divides Australia into five classes of remoteness, which are characterised by a measure of relative geographic access to services (ABS, 2023). The five classes are Major cities, Inner regional, Outer regional, Remote and Very remote.
A person’s remoteness area was classified based on the area of their usual residence recorded during their index hospitalisation. The 2016 Rural, Remote and Metropolitan Area (RRMA) classification was used.
Socioeconomic areas are reported using the Australian Bureau of Statistics’ Socio-Economic Indexes for Areas (SEIFA), whereby areas are classified based on social and economic information. Socio-Economic Indexes for Areas are divided into 5 groups, from the most disadvantaged (worst off) to the least disadvantaged (best off). This report used Index of Relative Socio-economic Disadvantage (IRSD) rankings, based on the 2016 Census, for the classification (ABS, 2018). Note, that this index refers to the average disadvantage of all people living in an area, not to the level of disadvantage of a specific individual.
A person’s Socioeconomic area was classified based on the area of their usual residence recorded during their index hospitalisation.
A person’s country of birth was classified based on records from admitted patient care during their index hospitalisation, as represented by the Standard Australian Classification of Countries 2016 (SACC). This is a four-digit, three-level hierarchical structure specifying major group, minor group and country (ABS, 2016).
ACSQHC (Australian Commission on Safety and Quality in Health Care) (2021) The Fourth Australian Atlas of Healthcare Variation - 2.2 Heart failure, ACSQHC, Australian Government, accessed 22 May 2025.
ABS (Australian Bureau of Statistics) (2017–18) National Health Survey: First results, ABS Website, accessed 21 May 2025.
ABS (2018) Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA), Australia, 2016, ABS Website, accessed 5 August 2025.
ABS (2022) National Health Survey, ABS Website, accessed 21 May 2025.
ABS (2016) Standard Australian Classification of Countries (SACC) 2016. ABS cat. no. 1269.0. Canberra: ABS.
ABS (July 2021–June 2026) Remoteness Areas, ABS Website, accessed 21 May 2025.
AIHW (Australian Institute of Health and Welfare) (2025) Heart, stroke and vascular disease – Australian facts, AIHW, Australian Government, accessed 21 May 2025.