While coronary heart disease (CHD) alone is a leading cause of death and a significant healthcare burden in Australia, when combined with type 2 diabetes (T2D), this comorbidity amplifies the patient’s risk of a heart attack.
As a consequence, CHD-T2D patients have more hospital admissions due to heart-related events and associated complications, as well as a higher chance of premature death.
As Deakin Health Economics PhD scholar Sangita Shakya explained, ‘The number of Australians living with CHD is projected to double by 2045, placing an increasing economic burden on Australia’s health system. So, we wanted to understand how people with CHD and T2D engage with primary and secondary care pathways, and what opportunities exist to improve outcomes and reduce avoidable rehospitalisation.’
Reporting their findings in the European Journal of Cardiovascular Nursing, Shakya and colleagues, including fellow researchers from the Deakin Institute for Health Transformation, examined healthcare pathways of more than 2,000 patients with CHD-T2D in Western Australia.
‘The 10 years of linked longitudinal datasets gave us a more complete picture of the healthcare journey of this patient cohort. We linked records from GP visits, pathology and pharmacy transactions to emergency admissions, inpatient stays and mortality records. This allowed us to understand what happened to patients after a heart attack, including their GP follow-up and long-term outcomes,’ said Shakya.
Importantly, the researchers found that patients who had more GP visits within the first year after a heart attack tended to experience better health outcomes, including improved survival and reduced rehospitalisation.
‘When we looked at the whole healthcare system, rather than siloed data, we found that GP visits were linked to better health outcomes. The findings highlight the importance of continuity of care and ongoing support after a patient is discharged from hospital.’
Lastly, and most importantly, this research indicates that recovery or hospital discharge is not the end of the healthcare journey for people with CHD and T2D.
‘We need greater emphasis on long-term patient management, particularly during the first year after the heart attack, and more support for patients living in regional and remote areas, or those with additional morbidities such as heart failure and chronic kidney disease,’ said Shakya.
Read the paper titled: Healthcare pathways and health outcomes among people with coronary heart disease and Type 2 diabetes in Australia: a linked data analysis
Read more about Sangita Shakya‘s research.
Impact
- An invited commentary, acknowledging Shakya et al.’s contribution to cardiovascular health services research, called for cardiovascular nurses to engage with patients after a heart event to improve outcomes and strengthen primary and secondary healthcare in Europe.
Read the commentary titled: Strengthening and deploying integrated cardiometabolic care for patients with coronary heart disease and type 2 diabetes - Sangita adapted this article to appear recently in Croakey titled: What happens after a heart attack matters more than we think
Share