Summary

The Better Cardiac Care for Aboriginal and Torres Strait Islander People project is an initiative of the Australian Health Ministers’ Advisory Council. It aims to reduce deaths and ill health from cardiac conditions among Indigenous Australians.

Five priority areas consisting of 21 measures were developed to monitor the progress of the project. In this fourth national report, data are reported for 14 measures. Thirteen measures reported in the earlier 3 reports are updated and results are also included for one new measure (1.2). Two previously reported measures (1.3 and 5.4) could not be reported due to issues with data availability (1.3) and data quality (5.4). Data for the remaining 5 measures not yet reported are currently under development and are expected to be included in future reports.

Key findings

Some progress has been made toward better cardiac care for Indigenous Australians. The level of access for cardiac-related health services has improved. The proportion of Indigenous Australians who received: Medicare-funded health assessments, cardiac-related diagnostic services under Medicare arrangements and the recommended intervention following hospitalisation for a severe heart attack has been increasing over time. The mortality rate from cardiac conditions is falling among the Indigenous population.

But there are still challenges in some areas: Indigenous Australians with suspected or confirmed cardiac disease are less likely to be reviewed by a specialist compared with non-Indigenous Australians; Indigenous Australians are less likely than non-Indigenous Australians to receive the recommended intervention following hospitalisation for a severe heart attack, and the incidence and recurrent rates of acute rheumatic fever among Indigenous Australians is much higher than among non-Indigenous Australians. In addition, while the mortality rate from cardiovascular disease is falling, it is still much higher among Indigenous Australians than non-Indigenous Australians.

Figure 1: Better Cardiac Care key findings

This infographic highlights the key findings of the report by each priority area. For priority area 1: early cardiovascular risk assessment and management, the age-standardised proportion of Indigenous Australians who received a Medicare Benefits Schedule health assessment rose from 3%25 in 2004–05 to 33%25 in 2017–18. For priority area 2: timely diagnosis of heart disease and heart failure, the age-standardised proportion of Indigenous Australians who made an MBS claim but cardiac-related diagnostic items rose from 7%25 in 2004–05 to 11%25 in 2017–18 but in 2017–18 Indigenous Australians with suspected or confirmed cardiac disease were less likely to be reviewed by a specialist than non-Indigenous Australians (39%25 versus 47%25, respectively). For priority area 3: guideline-based therapy for acute coronary syndrome, the age-standardised proportion of Indigenous Australians hospitalised for severe heart attack who received percutaneous coronary internation (PCI) rose from 26%25 in 2004–05 to 73%25 in 2016–17, but in 2016–17 Indigenous Australians were still less likely than non-Indigenous Australians to receive PCI (73%25 versus 81%25, respectively. For priority area 4: optimisation of health status and provision of ongoing preventive care, 68%25 of Indigenous Australians versus 54%25 of non-Indigenous Australians aged 65+ made MBS claims for a follow-up service within 12 months after a cardiovascular therapeutic procedure in 2016–17. For priority area 5: diagnosis, notification and follow-up of rheumatic heart disease, the incidence rate (crude) of acute rheumatic fever in 2017 was 111 per 100,000 population for Indigenous Australians versus 0.5 per 100,000 population for non-Indigenous Australians. For the summary measures: hospitalisation and mortality, the age-standardised mortality rate due to cardiac conditions for Indigenous Australians fell from 305 per 100,000 population in 1998 to 156 per 100,000 population in 2017, but in 2017, Indigenous mortality rate was 1.5 times the rate of non-Indigenous Australians. All rates shown in the infographic are age-standardised, except for rates shown in priority areas 4 and 5.

Note: All rates shown are age-standardised, except for rates shown in priority areas 4 and 5.