Heart, Lung and Circulation

Access to Cardiac Rehabilitation and Secondary Prevention Services in Australia: Is Geography Really the Issue?

      Background/Aims: Timely access is critical for optimising outcomes after a cardiac event. In Australia the overall attendance at cardiac rehabilitation remains low and in some communities’ access to basic services for secondary prevention is limited. The Cardiac Accessibility and Remoteness Index of Australia (Cardiac ARIA) is an objective, geographic measure reflecting access to cardiac services.
      Methods: Geographic information systems (GIS) were used to model the access to four basic services (general practitioner/nurse clinic, pharmacy, cardiac rehabilitation, pathology) within a one hour drive-time from each of Australia's 20,387 population locations. Australian Bureau of Statistics 2006 census data were used to identify key population characteristics within each of the five cardiac aftercare categories A (Access to all services ≤1 h) to E (No service ≤1 h).
      Results: Eighteen percent of the population locations were within category “A” zones with the remaining 82% located in zones with some limitation to recommended services. Sixteen percent (73,000) of the Indigenous population resided in population locations that had access to none or only one service. From the location data we estimated that 96% or 19 million Australians lived within one hour of the four basic services to support cardiac rehabilitation and secondary prevention, including 96% > 65 years and 75% of the Indigenous population.
      Conclusion: These results demonstrated that the majority of Australians had excellent “geographic” access to services after a cardiac event. Therefore further research is needed to identify which aspects of accessibility other than geographic distance to cardiac rehabilitation affect utilisation of services.