title: Congestive cardiac failure: urban and rural perspectives in Victoria.
abstract: 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.
authors.affiliation: Health Surveillance and Evaluation Section, Department of Human Services, Monash University, Melbourne, Victoria, Australia. zahid.ansari@dhs.vic.gov.au
authors.forename: Mohammad Z
authors.initials: MZ
authors.lastname: Ansari
authors.forename: Toni
authors.initials: T
authors.lastname: Henderson
authors.forename: Michael
authors.initials: M
authors.lastname: Ackland
authors.forename: Flavia
authors.initials: F
authors.lastname: Cicuttini
authors.forename: Vijaya
authors.initials: V
authors.lastname: Sundararajan
mesh_terms: 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