title: A comparison of age-standardised event rates for acute and chronic coronary heart disease in metropolitan and regional/remote Victoria: a retrospective cohort study.
abstract: Acute and chronic coronary heart disease (CHD) pose different burdens on health-care services and require different prevention and treatment strategies. Trends in acute and chronic CHD event rates can guide service implementation. This study evaluated changes in acute and chronic CHD event rates in metropolitan and regional/remote Victoria.
  
  
  
  Victorian hospital admitted episodes with a principal diagnosis of acute CHD or chronic CHD were identified from 2005 to 2012. Acute and chronic CHD age-standardised event rates were calculated in metropolitan and regional/remote Victoria. Poisson log-link linear regression was used to estimate annual change in acute and chronic CHD event rates.
  
  
  
  Acute CHD age-standardised event rates decreased annually by 2.9 % (95 % CI, -4.3 to -1.4 %) in metropolitan Victoria and 1.7 % (95 % CI, -3.2 to -0.1 %) in regional/remote Victoria. In comparison, chronic CHD age-standardised event rates increased annually by 4.8 % (95 % CI, +3.0 to +6.5 %) in metropolitan Victoria and 3.1 % (95 % CI, +1.3 to +4.9 %) in regional/remote Victoria. On average, age-standardised event rates for regional/remote Victoria were 30.3 % (95 % CI, 23.5 to 37.2 %) higher for acute CHD and 55.3 % (95 % CI, 47.1 to 63.5 %) higher for chronic CHD compared to metropolitan Victoria from 2005 to 2012.
  
  
  
  Annual decreases in acute CHD age-standardised event rates might reflect improvements in primary prevention, while annual increases in chronic CHD age-standardised event rates suggest a need to improve secondary prevention strategies. Consistently higher acute and chronic CHD age-standardised event rates were evident in regional/remote Victoria compared to metropolitan Victoria from 2005 to 2012.
authors.affiliation: Discipline of Exercise Physiology, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Xanthos
authors.affiliation: Discipline of Exercise Physiology, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia.
authors.forename: Brett A
authors.initials: BA
authors.lastname: Gordon
authors.affiliation: La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Begg
authors.affiliation: Department of Cardiology, Bendigo Health Care Group, Bendigo, Victoria, Australia.
authors.forename: Voltaire
authors.initials: V
authors.lastname: Nadurata
authors.affiliation: Discipline of Exercise Physiology, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia. m.kingsley@latrobe.edu.au.
authors.forename: Michael I C
authors.initials: MI
authors.lastname: Kingsley
mesh_terms: D000208:Acute Disease; D002908:Chronic Disease; D015331:Cohort Studies; D003327:Coronary Disease / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012424:Rural Population / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*; D014739:Victoria / Q000453:epidemiology
keywords: Angina; Cardiac disease; Health services; Myocardial infarction; Public health