Summary

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

Five priority areas comprising 21 measures were developed to monitor the progress of the project. Based on data availability, the previous annual reports covered 15 measures. This data update – the seventh in the series – updates data in the supplementary tables for 9 previously reported measures.

Updated data are available from the:

  • AIHW June 2020 national Key Performance Indicators (nKPIs) for Aboriginal and Torres Strait Islander primary health care data collection for Measure 1.2 on cardiovascular disease risk assessment
  • 2019–20 National Hospital Morbidity Database (NHMD) for Measure 3.1 on ST-segment-elevation myocardial infarction (STEMI) events treated by percutaneous coronary intervention (PCI); Measure 3.3 on acute coronary syndrome (ACS) events that included diagnostic angiography or revascularisation; Measure 3.5 on acute myocardial infarction (AMI) in-hospital mortality rates
  • 2020 National Rheumatic Heart Disease data collection for Measure 5.1 for the annual incidence of acute rheumatic fever (ARF) and rheumatic heard disease (RHD); Measure 5.2 for recurrent ARF; Measure 5.3 for preventive treatment with benzathine benzylpenicillin G (BPG doses)
  • 2019–20 NHMD for Measure 6.1 on the rates of hospitalisation for cardiac conditons
  • 2019–20 NHMD and 2020 National Mortality Database (NMD) for Measure 6.2 on mortality from cardiac conditions.

Five measures that use the Medicare Benefits Schedule (MBS) – Measures 1.1, 2.1, 2.3, 4.3 and 4.4 – could not be updated due to the unavailability of the updated Medicare Weighted Voluntary Indigenous Idenfifier database. For Measure 1.3, newer data from the National Aboriginal and Torres Strait Islander Health survey are not available. Measure 5.4 has not been reported since the 2018–19 report due to issues with data quality. Data for the remaining 5 measures are under development and 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 the recommended intervention following hospitalisation for a severe heart attack has been increasing over time. The mortality rate from cardiac conditions is falling.

But challenges remain in some areas.

  • Indigenous Australians are less likely than non-Indigenous Australians to receive the recommended intervention following hospitalisation for a severe heart attack.
  • While the mortality rate from cardiovascular disease is falling, it is still much higher than non-Indigenous Australians.

Guideline-based therapy for acute coronary syndrome

Indigenous Australians hospitalised for severe heart attack who received PCI.

  • 66% in 2019–20

    increase
  • 28% in 2006–07

In 2019–20, Indigenous Australians were about 20% less likely than non-Indigenous Australians to receive PCI.

ARFStrengthening the diagnosis, notification and follow-up of rheumatic heart disease

ARF recurrences per 100 patient-years among Indigenous Australians who should be receiving BPG.

  • 3.7 recurrences per 100 patient-years in 2016

    decrease
  • 3.1 recurrences per 100 patient-years in 2020

Hospitalisation and mortality

Mortality rate due to cardiac conditions for Indigenous Australians fell by 26%.

  • 205 per 100,000 population in 2006

    decrease
  • 151 per 100,000 population in 2020

In 2020, the mortality rate for Indigenous Australians was 1.8 times the rate of non-Indigenous Australians