Summary

Cardiovascular disease has a massive impact in Australia in terms of economic costs and burden of illness. Of particular concern are the consumption of health resources for invasive management of coronary heart disease and the heavy burden of disability due to stroke. Less widespread problems, such as rheumatic heart disease in Aboriginal and Torres Strait Islander communities, are also important.

Current data activity is uncoordinated and incomplete and fundamental information is lacking on groups which are especially at risk, such as the indigenous population, people of low socioeconomic status, and rural and remote communities. The lack of a nationwide monitoring system results in a limited capacity to address the problem and to evaluate strategies. Major health agencies have been concerned about this problem for some time. A recent government report on national health goals, targets and strategies, entitled Better Health Outcomes for Australians, recommended that a national system be established for monitoring cardiovascular disease, its risk factors and its management. Specific areas needing data collection were identified and it was recommended that a proposal for a national monitoring system be developed.

This report addresses that recommendation. It is the culmination of a consultative process which has included input from representatives of Federal, State and Territory health departments, the Australian Bureau of Statistics, non-government agencies, public health researchers and epidemiologists. The report proposes an integrated monitoring system based on the framework in Better Health Outcomes for Australians. The components of the proposed system include: primary prevention; risk factors; disease incidence; pre-hospital and emergency care; medical and surgical hospital care; rehabilitation; follow-up care; disease prevalence and functional status; palliative care and death (chapter 3). The report reviews national data sources which are available for monitoring these components, and makes recommendations for addressing gaps and deficiencies (chapter 6) and for the further development of the system once it is established (chapter 7).

This report also recommends a structure for the monitoring system (chapter 4), to consist of:

  • a national centre located at the Australian Institute of Health and Welfare;
  • regional collaborating centres; and
  • an advisory group to oversee the development and implementation of the monitoring system, determine its priorities and work program, and guide and review its work.

The advisory group will include representatives from State and Territory health departments, the National Heart Foundation, medical colleges, and academics with expertise in the fields of cardiovascular disease and data collection and analysis.

It is envisaged that the monitoring system will

  • report on national trends and patterns of cardiovascular disease and related data;
  • monitor goals and targets;
  • study differential rates of cardiovascular disease among population groups; and
  • provide data for the evaluation of preventive, diagnostic and treatment interventions, and for planning and managing health services nationally and locally.