Congestive cardiac failure: urban and rural perspectives in Victoria.
OBJECTIVE
Effective and timely care for congestive cardiac failure (CCF) should reduce the risks of hospitalisation. The purpose of this study is to describe variations in rates of hospital admissions for CCF in Victoria as an indicator of the adequacy of primary care services. Detailed analyses identify trends in hospitalisations, urban/rural differentials and variations by the Primary Care Partnerships (PCP).


METHODS
Acute care hospitals in Victoria.


METHODS
Routine analyses of age and sex standardised admission rates of CCF in Victoria using the Victorian Admitted Episodes Dataset from 1993-1994 to 2000-2001.


METHODS
All patients admitted to acute care hospitals in Victoria with the principal diagnosis of CCF between 1993-1994 and 2000-2001.


RESULTS
There were 8359 admissions for CCF in Victoria with an average of 7.37 bed days in 2000-2001. There was a significantly higher admission rate for CCF in rural areas compared to metropolitan in 2000/200--(2.53/1000 (2.44-2.62) and 1.80/1000 (1.75-1.85))--respectively. Small area analyses identified 17 PCP (14 of which were rural) with significantly higher admission rate ratios of CCF compared to Victoria.


CONCLUSIONS
Small area analyses of CCF have identified significant gaps in the management of CCF in the community. This may be a reflection of deficit in primary care availability, accessibility, or appropriateness. Detailed studies may be needed to determine the relative importance of these factors in Victoria for targeting specific interventions at the PCP level.
Ansari
Mohammad Z
MZ
Health Surveillance and Evaluation Section, Department of Human Services, Monash University, Melbourne, Victoria, Australia. zahid.ansari@dhs.vic.gov.au
Henderson
Toni
T
Ackland
Michael
M
Cicuttini
Flavia
F
Sundararajan
Vijaya
V
D017677:Age Distribution; D015897:Comorbidity; D005260:Female; D006297:Health Services Accessibility; D006302:Health Services Research; D006333:Heart Failure / Q000453:epidemiology* / Q000628:therapy; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000639:trends; D011320:Primary Health Care / Q000592:standards* / Q000639:trends; D011787:Quality of Health Care; D012111:Residence Characteristics / Q000706:statistics & numerical data; D019035:Rural Health Services / Q000592:standards* / Q000639:trends; D017678:Sex Distribution; D017062:Small-Area Analysis; D019037:Urban Health Services / Q000592:standards* / Q000639:trends; D014739:Victoria / Q000453:epidemiology