Hospital care for cardiovascular disease

All cardiovascular disease

There were 1.2 million hospitalisations where cardiovascular disease (CVD) was recorded as the principal or additional diagnosis in 2017–18, according to the Australian Institute of Health and Welfare (AIHW) National Hospital Morbidity Database. This represents 11% of all hospitalisations in Australia. Note that hospitalisation data presented here are based on admitted patient episodes of care, including multiple events experienced by the same individual.

In 2017–18 there were around:

  • 583,900 hospitalisations with CVD as the principal diagnosis (the diagnosis largely responsible for hospitalisation)(Figure 1).
  • 861,200 hospitalisations with CVD as an additional diagnosis (a coexisting condition with the principal diagnosis or a condition arising during hospitalisation that affects patient management).

    When CVD was listed as the principal diagnosis, the leading conditions were:

Figure 1: Major causes of hospitalisation for CVD (principal diagnosis), by sex, 2017–18

The bar graph shows that the most common major cause of cardiovascular disease (CVD) hospitalisations was coronary heart disease (161,814 hospitalisations), followed by heart failure and cardiomyopathy (70,648 hospitalisations), stroke (66,544 hospitalisations) and peripheral vascular disease (33,129 hospitalisations).The number of hospitalisations was higher among males than females for all major causes of CVD with the exception of hypertensive disease (4,694 and 8,305 hospitalisations, respectively).

Trends over time

The number of acute hospitalisations for CVD as the principal diagnosis increased by 34% between 2000–01 and         2017–18, from 391,400 to 523,800 hospitalisations. Despite increases in the number of hospitalisations, the age-standardised rate for acute care declined by 12% over this period, from 2,100 to 1,800 per 100,000 population. The rate of CVD hospitalisations among males was higher than that among females across the period (Figure 2).

Figure 2: Acute CVD (principal diagnosis) hospitalisations rates, by sex, 2000–01 to 2017–18

The line graph shows that the age-standardised rate of acute care hospitalisations for CVD has declined between 2000–01 and 2017–18 for both males and females. Among males, the rate decreased from 2,570 to 2,225 hospitalisations per 100,000 over this period. Among females, the rate declined from 1,614 to 1,419 hospitalisations per 100,000. The hospitalisation rate was consistently higher among males than females.

Age and sex

In 2017–18, CVD hospitalisation rates (as the principal diagnosis):

  • were overall 1.6 times as high for males as females (2,500 and 1,600 per 100,000 population, respectively) after adjusting for age. Age-specific rates were higher among males than females across all age groups.
  • increased with age, with over 4 in 5 (83%) CVD hospitalisations occurring in those aged 55 and over. CVD hospitalisation rates for males and females were highest in the 85 and over age group (21,000 and 16,000 per 100,000 population, respectively)—1.4 times as high as those in the 75–84 age group for males and 1.5 times as high among females (15,200 and 10,500 per 100,000, respectively) (Figure 3).

Figure 3: CVD hospitalisations (principal diagnosis), by age group and sex, 2017–18

The column graph show that CVD hospitalisation rate increased with increasing age. Males had a higher CVD hospitalisation rate than females across all age groups.  For males, the CVD hospitalisation rate increased from 167 hospitalisations per 100,000 population in those aged under 25 to 20,953 hospitalisations per 100,000 population in those aged 85 and over. For females the CVD hospitalisation rate increased from 154 hospitalisations per 100,000 population in those under 25 to 16,016 hospitalisations per 100,000 population those aged 85 and over.

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Variations between population groups

In 2017–18, CVD hospitalisation rates (as the principal diagnosis) increased with remoteness and socioeconomic disadvantage. Rates were:

  • around 30% higher among those living in Remote and very remote areas compared with those in Major cities. This pattern was largely driven by the rate for females―2,300 and 1,500 per 100,000 population, respectively―while for males, rates in these areas were more similar (2,800 and 2,400 per 100,000, respectively).
  • 20% higher for those in the lowest socioeconomic areas compared with the highest socioeconomic areas—2,200 and 1,800 per 100,000, respectively. This difference was similar for males and females (Figure 4).

Figure 4: CVD hospitalisations (principal diagnosis), by remoteness and socioeconomic area, 2017–18

The bar graph show that the age-standardised rate of CVD hospitalisations (principal diagnosis) increased with remoteness and socioeconomic disadvantage for both males and females. Males had a higher age-standardised rate of CVD hospitalisations than females across remoteness areas and socioeconomic groups.

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Aboriginal and Torres Strait Islander people

In 2017–18, there were around 14,900 hospitalisations for CVD (as the principal diagnosis) among Aboriginal and Torres Strait Islander people – a crude rate of 1,800 per 100,000 population.

After adjusting for differences in the age structure of the populations:

  • the rate among Indigenous Australians was overall 1.6 times as high as the non-Indigenous rate.
  • the disparity between Indigenous and non-Indigenous Australians was greater for females than males—1.9 times as high for females (3,000 and 1,500 per 100,000, respectively) and 1.4 times as high for males (3,400 and 2,400 per 100,000, respectively).

Coronary heart disease

There were over 229,600 hospitalisations where coronary heart disease (CHD) was recorded as the principal or an additional diagnosis in 2017–18. This represents 2.0% of all hospitalisations in Australia.

Seventy percent (161,800) of CHD hospitalisations were recorded as the principal diagnosis.

Where CHD was the principal diagnosis, hospitalisation rates:

  • were overall 2.5 times as high for males as for females. Age-specific rates were higher among males than females across all age groups.
  • increased with age and were highest among males aged 75–84 (4,500 per 100,000 population) and females aged 85 and over (2,400 per 100,000) (Figure 5).

Figure 5: CHD hospitalisations (principal diagnosis), by age group and sex, 2017–18

The column graph shows that males had a higher rate of CHD hospitalisations than females across all age groups. The rate of CHD hospitalisations peaked among males aged 75–84 (4,539 hospitalisations per 100,000 population). Among females, the rate was highest among those aged 85 years and over (2,411 hospitalisations per 100,000 population).

Heart failure and cardiomyopathy

There were around 177,800 hospitalisations where heart failure and cardiomyopathy was recorded as the principal or an additional diagnosis in 2017–18. This represents 1.6% of all hospitalisations in Australia.

Almost 40% of hospitalisations (70,600) for heart failure and cardiomyopathy were recorded as the principal diagnosis.

Where heart failure and cardiomyopathy was recorded as the principal diagnosis, hospitalisation rates:

  • were overall 1.5 times as high for males as females. Age-specific rates were higher among males than females in all age groups.
  • increased with age, with rates highest for males and females aged 85 and over (5,700 and 4,400 per 100,000 population)―at least 2.6 times as high as those aged 75–84 (2,200 and 1,600 per 100,000, respectively) (Figure 6).

Figure 6: Heart failure and cardiomyopathy hospitalisations (principal diagnosis), by age group and sex, 2017–18

The column graph shows that the heart failure and cardiomyopathy hospitalisation rate increased with age. Males had a higher heart failure and cardiomyopathy hospitalisation rate than females across all age groups.  For males, the hospitalisation rate increased from 5 hospitalisations per 100,000 population in those aged under 25, to 5,744 hospitalisations per 100,000 population in those aged 85 and over. For females, the hospitalisation rate increased from 3 hospitalisations per 100,000 population among those aged under 25 to 4,388 hospitalisations per 100,000 population in those aged 85 and over.

Stroke

There were around 82,000 hospitalisations where stroke was recorded as the principal or an additional diagnosis in 2017–18. This represents 0.7% of all hospitalisations in Australia. Over 81% (66,500) of hospitalisations for stroke were recorded as the principal diagnosis in 2017–18.

In 2017–18, where stroke was recorded as the principal diagnosis, hospitalisation rates:

  • were overall 1.4 times higher for males than females. Age-specific rates were higher among males than females from age 25 and over.
  • increased with age, with rates for males and females highest in those aged 85 and over (2,900 and 2,600 per 100,000 population, respectively)―around 1.5 times as high as those aged 75–84 among males (1,900 per 100,000) and around twice as high among females (1,300 per 100,000) (Figure 7).

Figure 7: Stroke hospitalisations (principal diagnosis), by age group and sex, 2017–18

The column graph shows that stroke hospitalisation rates increased with age. The rates for males were higher than for females from the age of 25 and over.  For males, the rate of stroke hospitalisations increased from 1,902 to 2,882 per 100,000 population between the age groups 75–84 and 85 and over. For females, the rate of stroke hospitalisations increased from 1,343 to 2,553 per 100,000 population between the age groups 75–84 and 85 and over.

Hospital procedures for CVD

Procedures are provided in hospitals to admitted patients to diagnose or treat CVD.

In 2017–18, common procedures performed in hospital for CVD were coronary angiography (137,900), percutaneous coronary intervention (44,900), echocardiography (44,000) and pacemaker insertion (18,100). The number of procedures to diagnose and treat CVD was higher among males than females.