Come a long way, long way to go—cardiac care for Aboriginal and Torres Strait Islander people

Friday, July 6, 2018

‘Today’s report on Aboriginal and Torres Strait Islander cardiac care released by the Australian Institute of Health and Welfare shows encouraging progress while also showing there is still some way to go to bridge gaps in treatment and mortality,’ Australian Healthcare and Hospitals Association (AHHA) Acting Chief Executive Dr Linc Thurecht said today.

‘On the plus side, the report shows access to care for Aboriginal and Torres Strait Islander people with heart conditions has improved markedly in recent years , while mortality rates have fallen.

‘On the minus side, Indigenous Australians continue to be much more likely than non-Indigenous Australians to be hospitalised for cardiac conditions, are less likely to use specialist services and in-hospital services, and are much more likely to die from a cardiac condition, either while in hospital or in the community.

‘And Indigenous Australians continue to suffer from rheumatic heart disease at disproportionate rates—it’s a condition rarely seen in non-Indigenous Australians.

‘At the coalface of healthcare—that is, primary or GP care—all Aboriginal and Torres Strait Islander people are eligible for an annual health assessment under Medicare. Many heart conditions get picked up at this stage, so it is pleasing to see that the proportion of Indigenous Australians accessing this health assessment rose from around 2% to about 27% overall between 2004–05 and 2015–16.

‘Over the same period, among Indigenous Australians hospitalised for a severe heart attack, the proportion who received recommended percutaneous coronary intervention rose from 26% to 65%, and those receiving recommended diagnostic and treatment procedures rose from 32% to 52%’ says Dr Thurecht.

‘The problem is that the respective rates for non-Indigenous Australians are 80% and 68%.

‘Also Indigenous Australians were less likely to be reviewed by a specialist after a cardiac-related procedure—76% compared with 92% for people under 65, and 93% compared with 97% for those 65 and over.

‘These kinds of treatment gaps, as well as discharges from hospital against medical advice, are what we are seeking to reduce through Stage 3 of the Lighthouse Hospital Project, which we are conducting jointly with the National Heart Foundation, funded by the Australian Government.

‘Stage 3 is currently under way in 18 hospitals around Australia. There are several complex factors at play that we are seeking to unravel through consultation and cooperation with local Aboriginal and Torres Strait Islander communities.

‘In terms of mortality rates, the AIHW report tells us that for Aboriginal and Torres Strait Islander people the in-hospital mortality rate due to cardiac conditions fell, if modestly, over the 9 years to 2016, and the overall mortality rate for the whole population due to cardiac conditions also fell. But the mortality rates were, respectively, 2 times and 1.5 times the rates for non-Indigenous Australians.

‘In summary, we are pleased with the improvements made in cardiac care for Aboriginal and Torres Strait Islander Australians, while remaining concerned at the persisting disparities when compared with non-Indigenous Australians.’

‘In view of the progress which has been made as a result of concerted effort and investment, we think that there is a strong case to expand the Lighthouse Hospital Project to cover all hospitals providing acute care for coronary heart disease, and to strengthen post-hospital care. The project could also be broadened to cover comorbidities—that is, conditions that go hand-in-hand with cardiac conditions’, Dr Thurecht said.

More information on the Lighthouse Project is available here. This media release is available online.

The Australian Healthcare and Hospitals Association is the national peak body for public and not-for-profit hospitals, and community and primary healthcare services.

Media enquiries:  Dr Linc Thurecht, A/Chief Executive, Australian Healthcare and Hospitals Association

0401 393 729