Key result
Age-standardised event rates for regional/remote Victoria were 30.3% higher for acute CHD and 55.3% higher for chronic CHD compared to metropolitan Victoria from 2005 to 2012.
Cohort (n=163,895)
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Acute CHD event rates are decreasing while chronic CHD event rates are increasing, with consistently higher rates in regional/remote areas compared to metropolitan areas, highlighting the need for improved secondary prevention and rural healthcare access.
BACKGROUND: Acute and chronic coronary heart disease (CHD) pose different burdens on health-care services and require different prevention and treatment strategies. Trends in acute and chronic CHD event rates can guide service implementation. This study evaluated changes in acute and chronic CHD event rates in metropolitan and regional/remote Victoria. METHODS: Victorian hospital admitted episodes with a principal diagnosis of acute CHD or chronic CHD were identified from 2005 to 2012. Acute and chronic CHD age-standardised event rates were calculated in metropolitan and regional/remote Victoria. Poisson log-link linear regression was used to estimate annual change in acute and chronic CHD event rates. RESULTS: Acute CHD age-standardised event rates decreased annually by 2.9 % (95 % CI, -4.3 to -1.4 %) in metropolitan Victoria and 1.7 % (95 % CI, -3.2 to -0.1 %) in regional/remote Victoria. In comparison, chronic CHD age-standardised event rates increased annually by 4.8 % (95 % CI, +3.0 to +6.5 %) in metropolitan Victoria and 3.1 % (95 % CI, +1.3 to +4.9 %) in regional/remote Victoria. On average, age-standardised event rates for regional/remote Victoria were 30.3 % (95 % CI, 23.5 to 37.2 %) higher for acute CHD and 55.3 % (95 % CI, 47.1 to 63.5 %) higher for chronic CHD compared to metropolitan Victoria from 2005 to 2012. CONCLUSION: Annual decreases in acute CHD age-standardised event rates might reflect improvements in primary prevention, while annual increases in chronic CHD age-standardised event rates suggest a need to improve secondary prevention strategies. Consistently higher acute and chronic CHD age-standardised event rates were evident in regional/remote Victoria compared to metropolitan Victoria from 2005 to 2012.
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Xanthos et al. (2016) conducted a cohort in Acute and chronic coronary heart disease (n=163,895). Regional/remote location vs. Metropolitan location was evaluated on Difference in acute CHD age-standardised event rates (+30.3%, 95% CI 23.5 to 37.2%). Age-standardised event rates for regional/remote Victoria were 30.3% higher for acute CHD and 55.3% higher for chronic CHD compared to metropolitan Victoria from 2005 to 2012.
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