Oral Presentation Australian Epidemiology Association ASM 2018

Benefit of cross-jurisdictional data linkage for enumerating cardiac procedures. (#4)

Judy Trevena 1 , Michael Nelson 1 , Marianne Gale 2 , Lee Taylor 1 , Kerry Chant 3 , Paul Kelly 4 , Leah Newman 5
  1. Centre for Epidemiology and Evidence, NSW Ministry of Health, North Sydney, NSW, Australia
  2. Office of the Chief Health Officer, NSW Ministry of Health, North Sydney, NSW, Australia
  3. Chief Health Officer, NSW Ministry of Health, North Sydney, NSW, Australia
  4. ACT Chief Health Officer & Deputy Director-General, Population Health Protection and Prevention, ACT Health, Canberra, ACT, Australia
  5. Epidemiology Section, Population Health Protection and Prevention, ACT Health, Canberra, ACT, Australia

Background
Ischaemic heart disease is the leading cause of death in Australia. After an acute myocardial infarction (AMI), timely assessment and revascularisation with percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) is critical to optimise patient outcomes. In rural and regional NSW, information on cross-border health care is necessary to assess the effectiveness of cardiac care pathways.

Aim
To estimate the contribution of linked cross-jurisdictional hospital and Medicare Benefits Schedule (MBS) data to the enumeration of AMI hospitalisations and cardiac procedures in NSW residents.

Methods
Data source: Linked NSW/ACT hospital and MBS records, July 2010 to June 2014.

Data analysis: Hospitalisations were defined using linked records for each incident AMI case. We estimated AMI hospitalisations and 7-day rates of angiography, PCI and CABG, and compared estimates obtained from linked NSW and NSW/ACT/MBS data.

Results
Linked NSW/ACT/MBS records increased ascertainment of AMI hospitalisations and cardiac procedures. While the increase in ascertainment was relatively small for NSW overall, there were marked increases for areas bordering other jurisdictions, particularly Southern NSW Local Health District where AMI hospitalisations increased by one third and angiography rates by 46 percentage points.

Conclusions
Linked cross-jurisdictional data is essential to understand pathways of cardiac care for NSW residents living in areas bordering other jurisdictions, and to evaluate adherence to AMI treatment guidelines for the population. Linked MBS data is useful where hospital data are not available, and for procedures performed in non-admitted settings