Investigating inequities in cardiovascular care and outcomes for Queensland Aboriginal and Torres Strait Islander people: Protocol for a hospital-based retrospective cohort data linkage project

Therese Kearns, Abbey Diaz, Lisa J. Whop, Suzanne P. Moore, John R. Condon, Ross M. Andrews, Judith M. Katzenellenbogen, Veronica Matthews, William Wang, Trisha Johnston, Catherine Taylor, Boyd Potts, Alex Kathage, Abdulla Suleman, Lucy Stanley, Louise Mitchell, Gail Garvey, Daniel Williamson

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Cardiovascular disease (CVD) represents a significant burden of disease for Aboriginal and Torres Strait Islander people, a population who continue to experience a lower life expectancy than other Australians. The aim of the Better Cardiac Care (BCC) Data Linkage project is to describe patient care pathways and identify disparities in care and health outcomes between Aboriginal and Torres Strait Islander people and other Queensland residents diagnosed with CVD in the state of Queensland.

Methods: This is a population-based retrospective cohort study using linked regional, state and national health and administrative data collections to describe disparities in CVD health care in primary and secondary prevention settings and during hospitalisation. The CVD cohort will be identified from the Queensland Hospital Admitted Patients Data Collection (QHAPDC) for admissions that occurred between 1 July 2010 to 31 June 2016 and include relevant International Classification of Disease codes for ischaemic heart disease, congestive heart failure, stroke, acute rheumatic fever and rheumatic heart disease. Person-level data will be linked by Data Linkage Queensland and the Australian Institute of Health and Welfare in accordance with ethical and public health approvals to describe the patient journey prior to, during and post the hospital admission.

Analysis
: This project will focus largely on descriptive epidemiological measures and multivariate analysis of clinical care standards and outcomes for Aboriginal and Torres Strait Islander people compared with other Queenslanders, including identification of risk factors for sub-optimal care and change over time. Variation in care pathways and patient outcomes will be compared by Indigenous status; sex; age group; remoteness of residence; year of index hospitalisation; and socio-economic status. Cox models for time-to-event data and mixed models or generalised estimating equations for longitudinal data will be used to measure change over time where temporal effects exist.
Original languageEnglish
Article numbere043304
JournalBMJ Open
Volume11
Issue number3
DOIs
Publication statusPublished - 19 Mar 2021

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