Heterogeneity of heart failure management programs in Australia

Driscoll, Andrea, Worrall-Carter, Linda, McLennan, Skye, Dawson, Anna, O'Reilly, Jan and Stewart, Simon (2006) Heterogeneity of heart failure management programs in Australia. European Journal of Cardiovascular Nursing, 5 1: 75-82. doi:10.1016/j.ejcnurse.2005.08.001

Author Driscoll, Andrea
Worrall-Carter, Linda
McLennan, Skye
Dawson, Anna
O'Reilly, Jan
Stewart, Simon
Title Heterogeneity of heart failure management programs in Australia
Journal name European Journal of Cardiovascular Nursing   Check publisher's open access policy
ISSN 1474-5151
Publication date 2006-03-01
Sub-type Article (original research)
DOI 10.1016/j.ejcnurse.2005.08.001
Open Access Status
Volume 5
Issue 1
Start page 75
End page 82
Total pages 8
Place of publication London, United Kingdom
Publisher Sage Publications
Language eng
Subject 110201 Cardiology (incl. Cardiovascular Diseases)
Formatted abstract
Heart Failure Management Programs (HFMPs) have proven to be cost-effective in minimising recurrent hospitalisations, morbidity and mortality. However, variability between the programs exists which could translate into variable health outcomes.


To survey the characteristics of HFMPs throughout Australia and to identify potential heterogeneity in their organisation and structure.

Thirty-nine post-discharge HFMPs were identified from a systematic search of the Australian health-care system in 2002. A comprehensive 19-item questionnaire specifically examining characteristics of HFMPs was sent to co-ordinators of identified programs in early 2003.

All participants responded with six institutions (15%) indicating that their HFMP had ceased operations due to a lack of funding. The survey revealed an uneven distribution of the 33 active HFMPs operating throughout Australia. Overall, 4450 post-discharge HF patients (median: 74; IQR: 24–147) were managed via these programs, representing only 11% of the potential caseload for an Australia-wide network of HFMPs. Heterogeneity of these programs existed in respect to the model of care applied within the program (70% applied a home-based program and 18% a specialist HF clinic) and applied interventions (30% of programs had no discharge criteria and 45% of programs prevented nurses administering/titrating medications). Sustained funding was available to only 52% of the active HFMPs.

Inequity of access to HFMPs in Australia is evident in relation to locality and high service demand, further complicated by inadequate funding. Heterogeneity between these programs is substantial. The development of national benchmarks for evidence-based HFMPs is required to address program variability and funding issues to realise their potential to improve health outcomes.
Keyword Chronic disease management programs
Chronic heart failure
Australian chronic disease programs
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Health and Rehabilitation Sciences Publications
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Created: Thu, 19 Mar 2009, 20:29:48 EST by Ms Sarada Rao on behalf of School of Health & Rehabilitation Sciences