Overview of Australia's state-wide cardiovascular program and reflections on its piloting between 2021 and 2024

Cardiovascular disease (CVD) remains a leading cause of death worldwide. Large-scale health system reforms, including new models of care are needed to reduce the burden of CVD. Between 2021 and 2024, Safer Care Victoria, together with the Victorian State and Australian Commonwealth governments, piloted an innovative Cardiovascular Program (Program) across the state of Victoria. The Program aimed to reduce avoidable readmissions for Victorians with CVD and improve access to CVD care for those living in regional and rural areas. The Program consisted of a range of initiatives including piloting rapid access clinics and virtual care pathways, as well as new roles to facilitate inpatient management and improve transition into the community. Across 30 health services, 10,670 people diagnosed with or at risk of CVDs received care through the Program. Compared to the pre-Program period, the Program generally reduced 30-day all-cause hospital readmissions for CVD by 1% to 14% (depending on condition type and initiative), and improved access to CVD care, including for people living in regional and rural areas. Critical success factors included seed funding, workforce buy-in and adaptability of initiatives. For long-term sustainability, the Program should consider resourcing, technical requirements, optimisation of data collection and relevance to diverse populations. Lessons learned from this pilot Program may prove useful for those jurisdictions where efforts to reduce readmission rates and improve access to cardiovascular care among rural patients have faced challenges.