Australian Institute of Health and Welfare (2021) Heart, stroke and vascular disease—Australian facts, AIHW, Australian Government, accessed 29 May 2022.
Australian Institute of Health and Welfare. (2021). Heart, stroke and vascular disease—Australian facts. Retrieved from https://www.aihw.gov.au/reports/heart-stroke-vascular-diseases/hsvd-facts
Heart, stroke and vascular disease—Australian facts. Australian Institute of Health and Welfare, 29 September 2021, https://www.aihw.gov.au/reports/heart-stroke-vascular-diseases/hsvd-facts
Australian Institute of Health and Welfare. Heart, stroke and vascular disease—Australian facts [Internet]. Canberra: Australian Institute of Health and Welfare, 2021 [cited 2022 May. 29]. Available from: https://www.aihw.gov.au/reports/heart-stroke-vascular-diseases/hsvd-facts
Australian Institute of Health and Welfare (AIHW) 2021, Heart, stroke and vascular disease—Australian facts, viewed 29 May 2022, https://www.aihw.gov.au/reports/heart-stroke-vascular-diseases/hsvd-facts
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This section provides an overview of hospital care for all cardiovascular diseases (CVD) in the Australian population. For information on hospitalisations for particular CVD subtypes, refer to the relevant page.
A hospitalisation for CVD may be for medical, surgical, or other acute care, for subacute care (for example rehabilitation) or for non-acute care (for example, maintenance care for a person with limitations due to a cardiovascular condition).
Many patients who are hospitalised with acute cardiovascular events will be cared for in a specialist unit:
In 2018–19, there were 591,000 hospitalisations where CVD was recorded as the principal diagnosis. This represented 5.2% of all hospitalisations in Australia in 2018–19.
Of these, 530,000 (90%) were for acute care—that is, care in which the intent is to perform surgery, diagnostic or therapeutic procedures in the treatment of illness or injury).
Of all hospitalisations for CVD in 2018–19:
The bar chart shows the number of hospitalisations for selected cardiovascular diseases in 2018–19, ranging from 161,000 for a principal diagnosis of coronary heart disease to 4,400 for rheumatic heart disease.
In 2018–19, rates of hospitalisation with CVD as the principal diagnosis:
The bar chart shows cardiovascular disease hospitalisation rates by age group in 2018–19. These were highest among men and women aged 85 and over (21,000 and 16,000 per 100,000 population).
The number of acute care hospitalisations with CVD as the principal diagnosis increased by 35% between 2000–01 and 2018–19, from 391,000 to 530,000 hospitalisations.
Despite increases in the number of hospitalisations, the age-standardised rate declined by 13% over this period, from 2,100 to 1,800 per 100,000 population.
The rate of CVD hospitalisations for males was higher than for females across the period, with both showing similar declines (Figure 3).
The line chart shows declines in age-standardised rates of male and female acute care CVD hospitalisations between 2000–01 and 2018–19, from 2,570 to 2,219 per 100,000 population for males, and from 1,614 to 1,398 for females.
The length of time that people spend in hospital for CVD has decreased over the past 3 decades. Among those hospitalised for 1 night or more with CVD as a principal diagnosis, the average length of stay declined from 9.6 days in 1993–94 to 7.9 days in 2007–08 and 6.0 days in 2018–19. In 2018–19, 28% of people admitted to hospital with CVD were discharged the same day.
Of those hospitalised with CVD in 2018–19, patients with stroke tended to stay longest—an average of 11.9 days, followed by patients with congenital heart disease (8.2 days) peripheral arterial disease (6.9 days), and coronary heart disease (4.4 days).
Average length of stay in hospital increases with age. Those aged 85 and over stayed an average of 7.2 days, compared with 4.9 days for those aged 25–34 years. The longer lengths of stay among older people reflect the increased complexity and multiplicity of their conditions.
Aboriginal and Torres Strait Islander people
In 2018–19, there were around 16,100 hospitalisations with a principal diagnosis of CVD among Aboriginal and Torres Strait Islander people.
After adjusting for differences in the age structure of the populations:
In 2018–19, CVD hospitalisation rates were almost 20% higher for people living in the lowest socioeconomic areas compared with those in the highest socioeconomic areas—2,200 and 1,800 per 100,000 population.
The disparity between the lowest and highest socioeconomic areas was greater for females than males (1.24 and 1.16 times as high) (Figure 4).
In 2018–19, CVD hospitalisation rates were around 30% higher among those living in Remote and very remote areas compared with those in Major cities (2,500 and 1,900 per 100,000 population).
This largely reflects disparities in female rates―2,200 and 1,500 per 100,000 population―for males, the difference was smaller (2,700 and 2,400 per 100,000).
Higher hospitalisation rates in Remote and very remote areas are likely to be influenced by the higher proportion of Aboriginal and Torres Strait Islander people living in these areas, who have higher rates of CVD than other Australians.
CVD patients are often transferred from a local regional hospital to a larger urban hospital where more intense or critical care can be provided. In 2018–19, 17% of CVD hospitalisations (principal and/or additional diagnosis) in Remote and very remote areas were transferred to another acute hospital, compared with 16% in Outer regional areas, 14% in Inner regional areas and 10% in Major cities.
The higher rates of transfers are often necessary because certain cardiac procedures, such as angiograms and cardiac revascularisation, are generally performed in large hospitals, which are predominantly located in urban areas.
The horizontal bar chart shows that male and female CVD hospitalisation rates in 2018–19 were higher among Indigenous Australians, people living in the lowest socioeconomic areas, and people living in remote and very remote areas.
This section reports on a range of common procedures which diagnose or treat CVD, and are performed on patients admitted to hospital.
Coronary angiography is a diagnostic procedure which provides a picture of the coronary arteries—those that supply blood to the heart itself—to determine whether they may be narrowed or blocked. A catheter is guided to the heart where a special dye is released into the coronary arteries before X-rays are taken.
Coronary angiography provides medical professionals with the information to decide on treatment options, such as the need for coronary revascularisation procedures.
Echocardiography is a diagnostic procedure which takes moving pictures of the heart using high frequency sound waves (ultrasound).
With these it is possible to measure the size of the various heart chambers, to study the appearance and motions of the heart valves, and to assess blood flow through the heart.
Imaging services, including intraoperative ultrasounds are not usually coded on hospital records, although transoesophageal echocardiogram (TOE) are an exception and are generally coded. Note, however, that the numbers reported here may be underestimates.
Percutaneous coronary interventions (PCIs) restore blood flow to blocked coronary arteries. There are two types: coronary angioplasty without stent, and coronary stenting.
Coronary angioplasty involves inserting a catheter with a small balloon into a coronary artery, which is inflated to clear the blockage. Coronary stenting is similar, but involves inserting a stent (an expandable mesh tube) into the affected coronary arteries.
Coronary artery bypass grafting (CABG) is a surgical procedure that uses blood vessel grafts to bypass blockages in the coronary arteries and restore adequate blood flow to the heart muscle. The surgery involves taking a blood vessel from a patient’s inner chest, arm or leg and attaching it to the vessels on the outside of the heart to bypass a blocked artery.
The line chart shows that the number of percutaneous coronary interventions for both males and females increased between 2000–01 and 2018–19, whereas the number of coronary artery bypass grafts declined.
Heart valve repair or replacement procedures are performed when the normal flow of blood through the heart is disrupted by damaged valves, making it harder for the heart to pump blood effectively. This can lead to heart failure. The damage to heart valves may be caused by acute rheumatic fever or rheumatic heart disease, coronary heart disease, or forms of congenital heart disease.
Pacemakers are small devices that are placed in the chest or abdomen to help control abnormal heart rhythms. These devices use electrical pulses to prompt the heart to beat at a normal rate.
A cardiac defibrillator implant is a device implanted into a patient’s chest that monitors the heart rhythm and delivers electric shocks to the heart when required to eliminate abnormal rhythms. They are effective in preventing sudden cardiac death in people at high risk of the life-threatening cardiac arrhythmia known as ventricular fibrillation.
Carotid endarterectomy is a procedure where atherosclerotic plaques are surgically removed from the carotid arteries in the neck, which supply blood to the brain. This procedure is used to reduce the risk of stroke caused by blockage.
A heart transplant involves implanting a working heart from a recently deceased organ donor into a patient. It is usually used to treat severe forms of heart failure or coronary artery disease.
The Australian and New Zealand Organ Donation Registry (ANZOD) records and reports on organ donation within Australia and New Zealand. Of the 548 deceased organ donors in 2019 in Australia, 123 (22%) had a heart retrieved. From these heart donors there were 113 heart transplant recipients. Of these, 2 received heart/double lung transplants and 4 received a combined heart/kidney transplant (ANZOD 2020).
AIHW 2020. MyHospitals. Admitted patients. Hospital resources 2018–19 tables. Table 5.6. Canberra: AIHW.
ANZOD (Australia and New Zealand Organ Donation Registry) 2020. ANZOD Annual Report 2020. ANZOD: Adelaide.
NHF (National Heart Foundation of Australia) & CSANZ (Cardiac Society of Australia and New Zealand) 2016. Australian clinical guidelines for the management of acute coronary syndromes 2016. Heart, Lung and Circulation 25: 895–951.
Stroke Foundation 2019. National Stroke Audit—acute services report 2019. Melbourne: Stroke Foundation.
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