Hospital utilisation patterns for cardiovascular disease (CVD) 12 months post first-ever acute coronary syndrome (ACS) in Aboriginal and non-Aboriginal patients

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Abstract

ntroduction: Aboriginal Australians have additive risk for rehospitalisation following an ACS admission including: comorbid conditions, higher rates of complications and discharge against medical advice. We compared hospital utilisation patterns in Aboriginal and non-Aboriginal patients following a first-ever ACS admission (index). Methods: Person-linked hospital records from Western Australia were used to identify CVD admissions in the 12-month period following index ACS in 2007-2010 for patients aged 25-84 years. Outcomes were time to first CVD admission, number of CVD admissions and total length of stay (LOS), comparing Aboriginal to non-Aboriginal patients. We performed separate multivariable regression analyses for elective and emergency admissions accounting for deaths. Results: Aboriginal patients (5.7% of 16,942) were younger, more commonly women, had higher rates of comorbid conditions, and were less likely to receive coronary artery procedures (59.6% vs 70.3%) at index ACS than non-Aboriginal patients. Aboriginal patients waited longer for a booked admission (10th percentile:165days; 95% CI:86-267 versus 47days; 95% CI:43-52) but shorter for an emergency admission (20days; 95% CI:16-25 versus 39days 95% CI:35-44) than non-Aboriginal patients. In the 12 months post-index ACS, Aboriginal patients had 18% fewer elective admissions (p = 0.04) but 46% more emergency admissions (p < 0.001). They had similar LOS for elective admissions (p = 0.427) but 38% greater LOS for emergency admissions (p = 0.007). Conclusions: Following index ACS, Aboriginal patients had higher hospital utilisation for emergency admissions but fewer elective admissions compared to non-Aboriginal patients. More proactive early management and follow-up for Aboriginal patients is needed, including greater understanding of patient- and service-related factors that impede this occurring.
Original languageEnglish
Pages (from-to)S331
Number of pages1
JournalHeart Lung and Circulation
Volume26
Issue numberSupplement 2
DOIs
Publication statusPublished - 2017
EventCardiac Society of Australia and New Zealand Annual Scientific Meeting and the International Society for Heart Research Australasian Section Annual Scientific Meeting - Perth Convention and Exhibition Centre, Perth, Australia
Duration: 10 Aug 201713 Aug 2017
Conference number: 65
http://www.csanz2017.com/

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