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RESEARCH ARTICLE
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Pattern of hospital admissions and costs associated with acute rheumatic fever and rheumatic heart disease in Australia, 2012–2017

Ingrid Stacey A B * , Judith Katzenellenbogen A , Joseph Hung C , Rebecca Seth D , Carl Francia E F , Bradley MacDonald A G , James Marangou H I J , Kevin Murray A and Jeffrey Cannon K
+ Author Affiliations
- Author Affiliations

A Cardiovascular Epidemiology Research Centre, School of Population and Global Health, The University of Western Australia, Perth, WA, Australia.

B Cardiology Population Health Laboratory, Victor Chang Cardiac Research Institute, Darlinghurst, Sydney, NSW, Australia.

C Medical School, The University of Western Australia, Perth, WA, Australia.

D School of Population Health, Curtin University, Perth, WA, Australia.

E School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Qld, Australia.

F Department of Physiotherapy, The Prince Charles Hospital, Brisbane, Qld, Australia.

G Department of General Paediatrics, Perth Childrens Hospital, Perth, WA, Australia.

H Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.

I Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia.

J Department of Cardiology, Fiona Stanley Hospital, Perth, WA, Australia.

K The Kids Research Institute Australia, Perth, WA, Australia.

* Correspondence to: Ingrid.Stacey@uwa.edu.au

Australian Health Review https://doi.org/10.1071/AH24148
Submitted: 31 May 2024  Accepted: 26 September 2024  Published: 22 October 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.

Abstract

Objective

This study aims to describe the pattern and trends in acute rheumatic fever (ARF)/rheumatic heart disease (RHD)-related hospitalisations and costs for Australians aged <65 years.

Methods

This retrospective linked data study measured trends in hospitalisations and costs for ARF, RHD and complications of ARF/RHD in Northern Territory, South Australia, Western Australia, Queensland and New South Wales between 1 July 2012 and 30 June 2017. Persons with ARF/RHD were identified from RHD registers and/or hospital records.

Results

Over the 5-year study period, 791 children, aged <16 years (86.3% Indigenous), and 2761 adults, aged 16–64 years (44.8% Indigenous), were hospitalised for ARF, RHD or associated complications. On average there were 296 paediatric admissions per year, increasing 6.1% annually (95% CI: 2.4–9.6%, P = 0.001) and 1442 adult admissions per year, increasing 1.7% annually (95% CI: 0.1–3.4%, P = 0.03). Total 5-year costs were AU$130.6 m (AU$17.6 m paediatric, AU$113.0 m adult). Paediatric costs were mostly for ARF-related admissions whereas adult costs mostly involved valvular surgery. Emergency admissions and air ambulance transfers were common, particularly for non-metropolitan residents.

Conclusions

Successful ARF/RHD prevention would deliver significant hospital cost savings. Investment in primary and specialist health care in regional areas may reduce emergency admissions and regional transfers, further reducing hospital burden.

Keywords: Aboriginal and Torres Strait Islander health, acute rheumatic fever, diagnosis related groups, End RHD in Australia: Study of Epidemiology (ERASE), hospitalisations, linked data, rheumatic heart disease.

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