Top

Journal of Public Health

Published in:

01-06-2010 | Original Article

Geographic variation in invasive cardiac procedure rates in New South Wales, Australia

Authors: Daminda P. Weerasinghe, Farhat Yusuf, Nicholas J. Parr

Published in: Journal of Public Health | Issue 3/2010

Abstract

Objectives

This study explores the contribution of socio-demographic factors to the geographic variation in coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) procedure rates in New South Wales, Australia.

Methods

With the utilisation of small area analysis and regression model techniques, the possible explanatory factors of the local government area (LGA) level variation in CABG and PCI rates in terms of coronary artery disease prevalence, supply and access to health-care services, socio-economic status and ethnic origin of the people were examined.

Results

Multivariate regression results show that distance to hospitals is negatively associated with LGA-specific CABG and PCI rates. The CABG rate is lower and PCI rate is higher in LGAs with higher percentages of European-born residents. Higher proportions of surgeries were recorded for relatively younger people in the lowest socio-economic LGAs.

Conclusions

The focus should be on educating people in the lowest socio-economic LGAs in lifestyle management in order to minimise surgical interventions at a younger age.

Available only for authorised users

ABS (2002) Basic community profile - 2001, NSW (State 1) Cat. No. 2001.0. Australian Bureau of Statistics, Canberra

AIHW, Davies J, Senes S (2002) Coronary angioplasty in Australia 1999 AIHW Cat. No. CVD 19, cardiovascular disease series no. 19. Australian Institute of Health and Welfare and National Heart Foundation of Australia, Canberra

AIHW, Davies J, Senes S (2003) Cardiac surgery in Australia 1999 AIHW Cat. No. CVD 23, cardiovascular disease series no. 21. Australian Institute of Health and Welfare, Canberra

Avato JL, Lai KK (2002) Impact of post-discharge surveillance on surgical site infection rates for coronary artery bypass procedures. Infect Control Hosp Epidemiol 23:364–367CrossRefPubMed

Black N, Langham S (1995) Coronary revascularisation: why do rates vary geographically in the UK? J Epidemiol Community Health 49:408–412CrossRefPubMed

Brown HS (2001) Income, location, and the demand for health care from public, nonprofit, and for-profit hospitals. J Health Care Finance 27:24–38PubMed

Burnley IH (1999) Transition and inequalities in acute myocardial infarction mortality in New South Wales, 1969–94. Aust N Z J Public Health 23:343–351CrossRefPubMed

Cain K, Diehr P (1992) Testing the null hypothesis in small area analysis. Health Serv Res 27:267–294PubMed

Carlisle DM, Valdez RB, Shapiro MF, Brook RH (1995) Geographic variation in rates of selected surgical procedures within Los Angeles County. Health Serv Res 30:27–42PubMed

Cooper JK, Johnson TP, Heller LE (1986) The influence of rural physicians' perception on referral patterns to a university hospital. J Rural Health 2:61–70CrossRefPubMed

Diehr P, Cain K, Ye Z, Abdul-Salam F (1993) Small area variation analysis: methods for comparing several diagnosis-related groups. Med Care 31:YS45–YS53PubMed

EOHCS: Healy J (2002) Health care systems in eight countries: trends and challenges: Australia. In Dixon A, Mossialos E (eds). London: The European Observatory on Health Care Systems, London School of Economics and Political Science

Gittelsohn A, Powe NR (1995) Small area variations in health care delivery in Maryland. Health Serv Res 30:295–317PubMed

Hardes GR, Dobson AJ, Lloyd DM, Leeder SR (1985) Coronary heart disease mortality trends and related factors in Australia. Cardiology 72:23–28CrossRefPubMed

Hyndman JC, Holman CD, Hockey RL, Donovan RJ, Corti B, Rivera J (1995) Misclassification of social disadvantage based on geographical areas: Comparison of postcode and collector's district analyses. Int J Epidemiol 24:165–176CrossRefPubMed

Lim L, O'Connell RL, Heller RF (1999) Differences in management of heart attack patients between metropolitan and regional hospitals in Hunter region of Australia. Aust N Z J Public Health 23:61–66CrossRefPubMed

McElduff P, Dobson AJ (2000) Trends in coronary heart diseases - has the socio-economic differential changed? Aust N Z J Public Health 24:465–473CrossRefPubMed

McLaughlin CG, Normolle DP, Wolfe RA, McMahon LF, Griffith JR (1989) Small-area variation in hospital discharge rates, Do socioeconomic variables matter? Med Care 27:507–521CrossRefPubMed

Rose G (1985) Sick individuals and sick populations. Int J Epidemiol 14:32–38CrossRefPubMed

Sexton PT, Sexton TH (2000) Excess coronary mortality among Australian men and women living outside the capital city statistical divisions. Med J Aust 172:370–374PubMed

Taylor R, Quine S, Lyle D, Bilton A (1992) Socioeconomic correlates of mortality and hospital morbidity differentials by Local Government Area in Sydney 1985–1988. Aust N Z J Public Health 16:305–314

Taylor R, Chey T, Bauman A, Webster I (1999) Socio-economic, migrant and geographic differentials in coronary heart disease occurrence in New South Wales. Aust N Z J Public Health 23:20–26CrossRefPubMed

Wennberg JE (1990) Small area analysis and the medical care outcome problem. In: Sechrest L, Perrin E, Bunker J (eds) AHCPR conference proceedings: research methodology: strengthening causal interpretations of nonexperimental data. Department of Health and Human Services, Rockville, Md, pp 177–206

Wennberg JE, Gittlesohn A (1982) Variation in medical care among small areas. Sci Am 246:120–134CrossRefPubMed

Yu XQ, Robertson C, Brett I (2000) Socioeconomic correlates of mortality differentials by local government area in rural northern New South Wales, 1981–1995. Aust N Z J Public Health 24:365–369CrossRefPubMed

Title: Geographic variation in invasive cardiac procedure rates in New South Wales, Australia
Authors: Daminda P. Weerasinghe
Farhat Yusuf
Nicholas J. Parr
Publication date: 01-06-2010
Publisher: Springer-Verlag
Published in: Journal of Public Health / Issue 3/2010
Print ISSN: 2198-1833
Electronic ISSN: 1613-2238
DOI: https://doi.org/10.1007/s10389-009-0296-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Geographic variation in invasive cardiac procedure rates in New South Wales, Australia

Abstract

Objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 3/2010

Andrew Clapham, Mary Robinson (eds) and Claire Mahon, Scott Jerbi (co-eds.): Realizing the Right to Health

Potential impact of a pilot training program on smoking cessation intervention for tuberculosis DOTS providers in Malaysia

Knowledge and practice regarding iodized salt among retail shopkeepers and extent of iodization of salt sold at the retail level in urban slums of Cuttack city in Orissa, India

Johannes Hartig, Eckhard Klieme, Detlev Leutner (eds): Assessment of Competencies in Educational Contexts

Use and understanding of nutrition information on food labels in six European countries

Contemporary exposure to cigarette smoke and noise of automobile manufacturing company workers