title: Inequitable provision of optimal services for patients with chronic heart failure: a national geo-mapping study.
abstract: OBJECTIVE
  To compare the location and accessibility of current Australian chronic heart failure (CHF) management programs and general practice services with the probable distribution of the population with CHF.
  
  
  METHODS
  Data on the prevalence and distribution of the CHF population throughout Australia, and the locations of CHF management programs and general practice services from 1 January 2004 to 31 December 2005 were analysed using geographic information systems (GIS) technology.
  
  
  METHODS
  Distance of populations with CHF to CHF management programs and general practice services.
  
  
  RESULTS
  The highest prevalence of CHF (20.3-79.8 per 1000 population) occurred in areas with high concentrations of people over 65 years of age and in areas with higher proportions of Indigenous people. Five thousand CHF patients (8%) discharged from hospital in 2004-2005 were managed in one of the 62 identified CHF management programs. There were no CHF management programs in the Northern Territory or Tasmania. Only four CHF management programs were located outside major cities, with a total case load of 80 patients (0.7%). The mean distance from any Australian population centre to the nearest CHF management program was 332 km (median, 163 km; range, 0.15-3246 km). In rural areas, where the burden of CHF management falls upon general practitioners, the mean distance to general practice services was 37 km (median, 20 km; range, 0-656 km).
  
  
  CONCLUSIONS
  There is an inequity in the provision of CHF management programs to rural Australians.
authors.affiliation: Faculty of Health Sciences, University of South Australia, Adelaide, SA. simon.stewart@baker.edu.au
authors.forename: Robyn A
authors.initials: RA
authors.lastname: Clark
authors.forename: Andrea
authors.initials: A
authors.lastname: Driscoll
authors.forename: Justin
authors.initials: J
authors.lastname: Nottage
authors.forename: Skye
authors.initials: S
authors.lastname: McLennan
authors.forename: David M
authors.initials: DM
authors.lastname: Coombe
authors.forename: Errol J
authors.initials: EJ
authors.lastname: Bamford
authors.forename: David
authors.initials: D
authors.lastname: Wilkinson
authors.forename: Simon
authors.initials: S
authors.lastname: Stewart
mesh_terms: D000367:Age Factors; D000368:Aged; D001315:Australia / Q000453:epidemiology; D003710:Demography; D005194:Family Practice / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006333:Heart Failure / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D020380:Needs Assessment / Q000706:statistics & numerical data; D044382:Population Groups / Q000706:statistics & numerical data; D015995:Prevalence; D011365:Professional Practice Location / Q000706:statistics & numerical data; D012041:Regional Medical Programs / Q000706:statistics & numerical data; D012423:Rural Health / Q000706:statistics & numerical data; D014504:Urban Health / Q000706:statistics & numerical data