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 language | English |
---|---|
Pages (from-to) | 331-337 |
Number of pages | 7 |
Journal | Heart Lung and Circulation |
Volume | 26 |
Issue number | 4 |
DOIs | |
Publication status | Published - 1 Apr 2017 |
Event | Cardiac 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 2017 → 13 Aug 2017 Conference number: 65 http://www.csanz2017.com/ |