Population monitoring of coronary heart disease in the modern era

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Despite major reductions in mortality from heart attack over the past three decades, coronary heart disease (CHD) remains the leading cause of death and disability in Australia. It generates very large health costs and is one of five National priority areas for disease prevention and control. The most important manifestations of CHD are heart attacks, which require urgent hospital treatment, or sudden death, generally outside hospital. Accurate information to monitor trends in the incidence and outcomes of heart attack that can be used to assess the effectiveness for public health programs, establish requirements for clinical services, improve quality of care, and support studies of costs of health care, is essential. This study will use the unique capacity for medical record linkage in Western Australia (WA) to establish a comprehensive system to monitor the incidence, outcomes and emergency treatment of heart attack. It will combine information from a number of data sources including the hospital statistical system, emergency departments, ambulance services, laboratories and departments of cardiology. It will also obtain information from Commonwealth Department of Health and Aged care about the prescribing of selected medications, such as cholesterol lowering drugs, used in for the prevention of heart disease. Within this framework, it will undertake a number of sub-studies to improve the accuracy of information about heart attacks in the hospital statistical system to ensure consistency in measuring future trends, provide clinicians with state-wide information about outcomes of hospital care and the uptake of proven therapies, provide health administrators with information for planning services, and policy makers about the most cost-effective options for the preventions and control of heart disease.