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.
Key Words
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Article info
Publication history
Published online: June 13, 2017
Accepted:
June 8,
2017
Received in revised form:
May 25,
2017
Received:
September 6,
2016
Footnotes
Funding: G.M. is supported by a National Health and Medical Research Council (NHMRC) Practitioner Fellowship. S.S. receives fellowship support from an NHMRC research Fellowship (1041796). C.T. is supported by the Centre of Excellence to Reduce Inequality in Heart Disease (1044897). The study was also supported in part by the Victorian Government's Operational Infrastructure Support Program.
Identification
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© 2017 Elsevier Inc. All rights reserved.
