Expenditure on cardiovascular disease

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What is expenditure on cardiovascular disease?

This section provides recent data on health care expenditure on cardiovascular disease (CVD), with details by type of condition, health care service, age group, and sex.

It includes expenditure by the Australian Government, state, territory and local governments and the non-government sector (including private health insurance and individual contributions).

These estimates report direct, allocated and recurrent expenditure only. They do not account for the total amount spent on cardiovascular health.

Further information on how the estimates were derived is available from the Disease expenditure in Australia web report.

How much is spent on cardiovascular disease?

In 2018–19, an estimated 8.7% of total allocated expenditure in the Australian health system ($11.8 billion) was attributed to CVD.

CVD was the disease group with the second highest expenditure in 2018–19, behind musculoskeletal disorders ($14.0 billion). The high expenditure on CVD reflects its position as a leading cause of death and a major contributor to the overall burden of disease in Australia.

The most expensive cardiovascular conditions in 2018–19 were CHD, AF and stroke. An estimated:

  • 19.9% of CVD expenditure ($2.4 billion) was spent on CHD
  • 10.2% of CVD expenditure ($1.2 billion) was spent on AF
  • 5.6% of CVD expenditure ($663 million) was spent on stroke (Figure 1).

Figure 1: Health care expenditure on selected cardiovascular conditions, 2018–19

 

The horizontal bar chart shows the leading cardiovascular conditions in terms of health care expenditure in 2018–19. Coronary heart disease was most costly, estimated at $2,352 million followed by atrial fibrillation and flutter at $1,202 million.

Where is the money spent?

In 2018–19, over two thirds of allocated CVD expenditure (69% or $8.1 billion) was spent on hospital services. This included expenditure on public hospital admitted patients ($4.4 billion), private hospital services ($2.6 billion), public hospital outpatients ($687 million) and public hospital emergency departments ($443 million).

Another 15% ($1.8 billion) related to non-hospital medical services (primary care), comprising GP services ($880 million), specialist services ($479 million), medical imaging ($193 million), pathology ($204 million) and allied health and other services ($35 million).

A small amount of CVD expenditure (1% or $107 million) was spent on dental services.

The remaining 15% ($1.8 billion) was spent on prescription pharmaceuticals dispensed through the PBS (Figure 2). 

Figure 2: Health care expenditure on cardiovascular disease, by area of expenditure, 2018–19

The horizontal bar chart shows health care expenditure areas for cardiovascular disease in 2018–19. The most costly areas were Public hospital admitted patients at $4,419 million, Private hospital services at $2,581 million and Pharmaceutical benefits scheme at $1,809 million.

Expenditure was distributed differently for each cardiovascular condition. To illustrate, in 2018–19:

  • hospital services represented 83% of CHD expenditure, 61% of AF expenditure, and 90% of stroke expenditure
  • non-hospital medical services represented 9.4% of CHD expenditure, 11% of AF expenditure, and 7.1% of stroke expenditure
  • Pharmaceutical Benefits Scheme costs represented 6.6% of CHD expenditure, 28% of AF expenditure, and 3.0% of stroke expenditure.

Who is it spent on?

Expenditure on CVD in 2018–19 was low among young people, but increased sharply from age 45–54 years, to be highest among males aged 65–74 and females aged 75–84 (Figure 3).

From age 45–54 years, expenditure on CVD was higher among males than females, except at age 85 and over, reflecting the higher prevalence of CVD among males. At ages 55–64, 60–64 and 65–74 years, expenditure for males was 1.7 times as high as for females.

Most of this difference was related to expenditure on hospital services, where a total of $4.9 billion was spent on males, compared with $3.2 billion on females.

Expenditure on non-hospital medical services (primary care) was higher among females ($902 million, compared to $887 million among males), despite the higher prevalence of CVD among males.

Expenditure in the area of prescription pharmaceuticals was higher among males ($951 million) compared to females ($848 million).

Figure 3: Health care expenditure on cardiovascular disease, by age and sex, 2018–19

The bar chart shows health care expenditure for cardiovascular disease in 2018–19 was highest among males aged 65–74 at $1,966 million, and males aged 75–84 at $1,680 million. Expenditure was higher for females than males in the 85 and over age group.

Aboriginal and Torres Strait Islander people

In 2015–16, expenditure on hospitalisations for Indigenous people with CVD was $173.3 million—equivalent to 3.1% of total expenditure on hospitalisations for people with CVD. This equated to $230 per Indigenous person, compared with $236 for non-Indigenous persons (AIHW & NIAA 2020).

Hospitalisation for rheumatic heart disease (RHD) among Aboriginal and Torres Strait Islander people accounted for 6.8% of total Indigenous hospital expenditure on CVD. The per person expenditure on RHD hospitalisation for the Indigenous population was almost 5 times the per person expenditure for the non-Indigenous population.