Rural-Urban Differences in Outcomes of Acute Cardiac Admissions in a Large Health Service.

Area of Science:

• Cardiology
• Public Health
• Rural Health

Background:

• Cardiovascular disease (CVD) is a major cause of death and illness.
• Living in rural or remote areas is linked to a higher risk of CVD.
• The specific impact of rurality on CVD outcomes requires further investigation.

Purpose of the Study:

• To compare CVD outcomes between rural/remote and metropolitan patients.
• To assess differences in mortality, readmissions, and emergency department (ED) visits.
• To analyze outcomes for heart failure (HF), atrial fibrillation (AF), and acute coronary syndrome (ACS).

Main Methods:

• Retrospective observational study in Hunter New England, Australia (2008-2021).
• Included index hospitalizations for HF, AF, and ACS.
• Compared outcomes for patients from rural/remote versus metropolitan areas.

Main Results:

• Rural/remote patients had higher 30-day readmissions (OR 1.19) and total readmissions (IRR 1.19).
• Rural/remote patients had more ED presentations (IRR 1.39).
• No significant difference in overall mortality; however, rural/remote ACS patients showed increased mortality (HR 1.05).

Conclusions:

• Rural Australians with CVD experience higher readmission rates and ED visits.
• This highlights healthcare disparities and the need for improved access to specialized care post-discharge.
• Interventions are needed to address challenges faced by rural populations in managing CVD.