Pattern and Outcome of Heart Failure-Related Hospitalization Over 5 Years in a Remote Australian Population: A Retrospective Administrative Data Cohort of 617 Indigenous and non-Indigenous Cases

J Card Fail. 2017 Oct;23(10):729-738. doi: 10.1016/j.cardfail.2017.06.002. Epub 2017 Jun 13.

Abstract

Objective: The aim of this work was to understand the pattern and outcomes for heart failure (HF)-related hospitalization among Indigenous and non-Indigenous patients living in Central Australia.

Methods and results: A retrospective analysis of administrative data for patients presenting with a primary or secondary diagnosis of HF to Central Australia's Alice Springs Hospital during 2008-2012 was performed. The population rate of admission and subsequent outcomes (including mortality and readmission) during the 5-year study period were examined. A total of 617 patients, aged 55.8 ± 17.5 years and 302 (49%) female constituted the study cohort. The 446 Indigenous patients (72%) were significantly younger (50.8 ± 15.9 vs 68.7 ± 14.9; P < .001) and clinically more complex compared with the non-Indigenous patients. Annual prevalence of any HF hospitalization was markedly higher in the Indigenous population (1.9%, 95% CI 1.7-2.1) compared with the non-Indigenous population (0.5%, 95% CI 0.4-0.6); the greatest difference being for women. Overall, non-Indigenous patients had poorer outcomes and were significantly more likely to die (P < .0001), but this was largely driven by age differences. Alternatively, Indigenous patients were significantly more likely to have a higher number of hospitalizations, although indigeneity was not a predictor for 30- or 365-day rehospitalization from the index admission.

Conclusion: The pattern of HF among Indigenous Australians in Central Australia is characterized by a younger population with more clinically complex cases and greater health care utilization.

Keywords: Epidemiology; Indigenous; health outcomes; heart failure; remote.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Australia
  • Databases, Factual / statistics & numerical data
  • Databases, Factual / trends*
  • Female
  • Heart Failure / diagnosis
  • Heart Failure / epidemiology*
  • Heart Failure / therapy
  • Hospital Administration / statistics & numerical data
  • Hospital Administration / trends*
  • Hospitalization / trends*
  • Humans
  • Male
  • Middle Aged
  • Native Hawaiian or Other Pacific Islander* / statistics & numerical data
  • Patient Acceptance of Health Care / statistics & numerical data
  • Population Surveillance* / methods
  • Retrospective Studies
  • Statistics as Topic / trends
  • Time Factors
  • Treatment Outcome