Variations in heart failure hospitalisation rates by socioeconomic status, Victoria, Australia

Abstract

This paper analyses variations in heart failure (HF) hospitalisation rates by community socioeconomic status (SES) in Victoria, from 1 July 2011 to 30 June 2014. The data was taken from the Victorian Admitted Episodes Dataset, the Australian Bureau of Statistics' Estimated Resident Population and Index of Relative Socioeconomic Disadvantage and the Victorian Population Health Survey. There were over 38,000 HF hospitalisations over the period. The age-standardised HF rates per 10,000 population varied inversely (r = -0.362, p<.01) with SES across 79 Local Government Areas (LGA). The coefficient of variation for HF hospitalisation rates was 0.35 and 0.14 for all admissions, indicating that HF hospitalisations have a greater variation by LGA. Communities with high HF rates also had high rates of current smokers (r = 0.24), chronic obstructive pulmonary disease (r = 0.57), renal failure (r = 0.54), diabetes (r = 0.24), musculoskeletal malignant neoplasms (r = 0.35) and Disability Support Pension recipients (r = 0.38). The average 30-day HF readmission rate was 25.5%, the second highest of all admission categories. The HF readmission rates also varied inversely (r = -0.38, p<.01) with SES. Investigating variations in HF by SES may uncover modifiable pathways. Given the high readmission rates, comorbidities and population ageing, there is a case for improving health outcomes for HF patients.