Regional variation in coronary mortality within Tasmania.
OBJECTIVE
To measure regional rates of mortality from ischaemic heart disease (IHD) within Tasmania and to analyse factors associated with regional differences.


METHODS
Descriptive epidemiological study.


METHODS
Community-based study.


METHODS
Male residents of Tasmania aged 30-69 years dying from IHD between 1986 and 1989.


METHODS
Coronary death as coded by the Australian Bureau of Statistics and place of death validated by hospital and community data.


RESULTS
This study identifies substantial differences in coronary death rates among the three Health Regions of Tasmania. These differences are real and are not caused by variations in diagnostic or coding practices between regions. The two northern Health Regions, which represent approximately 52% of the total population, account for 98% of the excess mortality from IHD in Tasmania compared with the national rate. More detailed analysis of these differences suggests that variation in the number of deaths occurring in hospital contributes significantly to the regional differences in death rate from IHD.


CONCLUSIONS
Rates of coronary mortality in Tasmania have been significantly higher than in all other Australian States for much of the past decade because of a higher death rate within the population of the northern half of Tasmania. Differences in mortality rates between regions in Tasmania provide a focus for further study into the causes of the unacceptably high rates of death from IHD in Tasmania and underline the need for the funding of a coronary register in Tasmania.
Sexton
P T
PT
Department of Medicine, University of Tasmania, Hobart.
Jamrozik
K
K
Walsh
J
J
Thomson
A
A
Rundle
S
S
D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D003327:Coronary Disease / Q000145:classification / Q000175:diagnosis / Q000401:mortality*; D003625:Data Collection / Q000379:methods; D003644:Death Certificates; D003710:Demography; D017052:Hospital Mortality; D006753:Hospital Records; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D012307:Risk Factors; D013648:Tasmania / Q000453:epidemiology