Baseline characteristics and crude mortality of metropolitan versus rural patients with a ‘first-ever’ (index) admission for heart failure between 2000 and 2009
| Description | Metropolitan, n (%) | Rural, n (%) | p Value |
|---|---|---|---|
| Cases by ARIA classification1 | |||
| Major city | 9006 (69.9) | ||
| Inner regional | 3874 (30.1) | 1182 (26.3) | |
| Outer regional | 1807 (40.2) | ||
| Remote | 477 (10.6) | ||
| Very remote | 1033 (23.0) | ||
| Total cases | 12 880 (74.1) | 4499 (25.9) | |
| Women, n (%) | 5511 (42.8) | 1833 (40.7) | 0.017 |
| Mean age±SD (years) | 70.8±11.7 | 67.5±13.4 | <0.001 |
| Age groups (years), n (%) | |||
| 20–34 | 167 (1.3) | 117 (2.6) | <0.001 |
| 35–49 | 655 (5.1) | 382 (8.5) | |
| 50–64 | 2294 (17.8) | 1039 (23.1) | |
| 65–84 | 9764 (75.8) | 2961 (65.8) | |
| Aboriginal patients, n (%) | 241 (1.9) | 772 (17.2) | <0.001 |
| Length of stay, mean days±SD | 7.1±8.6 | 6.4±15.8 | 0.001 |
| Hospital type | |||
| Metro tertiary/teaching | 7212 (56.0) | 543 (12.1) | <0.001 for all |
| Metro/non-teaching | 1282 (10.0) | 28 (0.6) | |
| Rural regional | 48 (0.4) | 1524 (33.9) | |
| Rural district/small | 58 (0.5) | 1835 (40.8) | |
| Private | 4280 (33.2) | 569 (12.7) | |
| Emergency admission, n (%) | 12 095 (93.9) | 4265 (94.8) | 0.028 |
| Private health insurance, n (%) | 4197 (32.6) | 915 (20.3) | <0.001 |
| SEIFA (socioeconomic status), n (%) | |||
| First quintile (most disadvantaged) | 3 (0.2) | 1182 (26.5) | <0.001 for all |
| Second quintile | 1693 (13.2) | 1085 (24.3) | |
| Third quintile | 4827 (37.4) | 1476 (33.1) | |
| Fourth quintile | 2918 (22.6) | 631 (14.1) | |
| Fifth quintile (least disadvantaged) | 3439 (26.6) | 89 (2.0) | |
| Source of referral—professional, n (%) | |||
| General practitioner | 628 (4.9) | 838 (18.4) | <0.001 |
| Specialist clinician | 3235 (25.2) | 688 (15.1) | |
| Outpatient department clinician | 534 (4.1) | 137 (3.0) | |
| ED clinician | 7650 (59.6) | 2527 (55.6) | |
| Hospital clinician | 89 (0.7) | 67 (1.5) | |
| Community health clinician | 16 (0.1) | 36 (0.8) | |
| Others | 106 (0.8) | 33 (0.7) | |
| Missing | 572 (4.5) | 221 (4.9) | |
| Mode of transport to hospital, n (%) | |||
| Private/public transport | 6193 (48.3) | 2952 (64.9) | <0.001 |
| Ambulance––patient transport only | 542 (4.2) | 88 (1.9) | |
| Ambulance––emergency | 4938 (38.5) | 884 (19.4) | |
| Royal Flying Doctor Service | 16 (0.1) | 130 (2.9) | |
| Other | 115 (0.9) | 156 (3.4) | |
| Missing | 1026 (8.0) | 337 (7.4) | |
| Comorbidities, n (%)* | |||
| All ischaemic heart disease† | 6426 (49.9) | 1895 (42.1) | 0.001 |
| Acute myocardial infarction | 2242 (17.4) | 636 (14.1) | <0.001 |
| Unstable angina | 1987 (15.4) | 485 (10.8) | <0.001 |
| Hypertension | 7194 (55.9) | 2408 (53.5) | 0.007 |
| Atrial fibrillation | 5579 (43.3) | 1692 (37.6) | <0.001 |
| Diabetes | 4104 (31.9) | 1543 (34.3) | 0.003 |
| Chronic kidney disease | 2851 (22.1) | 918 (20.4) | 0.015 |
| Renal failure | 415 (3.2) | 181 (4.0) | 0.012 |
| COPD | 2600 (20.2) | 1146 (25.5) | <0.001 |
| Cerebrovascular disease | 1404 (10.9) | 391 (8.7) | <0.001 |
| Rheumatic heart disease/rheumatic valvular heart disease | 1868 (14.5) | 526 (11.7) | <0.001 |
| Valvular heart disease, non-rheumatic | 2663 (20.7) | 703 (15.6) | <0.001 |
| Interventions, n (%) | |||
| History of PCI | 779 (6.1) | 203 (4.5) | <0.001 |
| History of CABG | 342 (2.7) | 118 (2.6) | 0.891 |
| Index PCI | 228 (1.8) | 36 (0.8) | <0.001 |
| Index CABG | 374 (2.9) | 86 (1.9) | <0.001 |
| Coronary angiography | 6003 (46.6) | 1711 (38.0) | <0.001 |
| Charlson Index n (%) | |||
| 0 | 73 (0.6) | 32 (0.7) | |
| 1–2 | 5780 (44.9) | 2158 (48.0) | 0.001 for all |
| 3–4 | 3474 (27.0) | 1164 (25.9) | |
| >4 | 3553 (27.6) | 1145 (25.4) | |
| Crude cumulative mortality | |||
| 30-day case death‡ | 838 (6.6) | 306 (6.9) | 0.474 |
| 1-year mortality§ | 2364 (20.5) | 829 (20.7) | 0.799 |
| Mean presentations to ED within 1-year follow-up, n±SD | 2.8±3.1 | 4.9±5.7 | <0.001 |
Continuous variables expressed as mean±SD. Categorical variables expressed as proportions, n (%). p Value is for difference between metro and rural patients.
*Patients could have multiple comorbidities.
†All ischaemic heart disease includes acute myocardial infarction.
‡Patients admitted in December 2009 were excluded from analysis.
§Year 2009 was used as a follow-up period.
ARIA, Accessibility/Remoteness Index of Australia; CABG, coronary artery bypass grafting; COPD, chronic obstructive pulmonary disease; ED, emergency department; PCI, percutaneous coronary intervention; SEIFA, Socioeconomic Indices for Areas.