Letters
Cardiovascular diseases
Volume 187 - Issue 5

Inequitable provision of optimal health services for patients with chronic heart failure: a national geo-mapping study

Authors:  Robyn A Clark, Andrea Driscoll, Justin Nottage, Skye McLennan, David M Coombe, Errol J Bamford, David Wilkinson and Simon Stewart

Med J Aust 2007; 187 (5): 318-319. || doi: 10.5694/j.1326-5377.2007.tb01264.x
Published online: 3 September 2007
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In reply: We thank Dodd for her commentary on our article.1 We concur with many of the highlighted issues relating to our suboptimal response to the burden and management of chronic heart failure (CHF) in rural and remote Australia. These include the lack of rigorous epidemiological data and lack of specialist services “beyond city limits”.

Unfortunately, we have limited space to respond fully. However, we re-emphasise that, although our previous estimates2 complement that of the Canberra Study,3 neither can replace an Australia-wide study of CHF that samples metropolitan, regional, rural and Indigenous communities. We also stand by (within the context of the stated limitations) the accuracy of our mapping of the CHF programs and the location of general practice services in Australia for the study period. Our geo-mapping approach and data have been well validated by the National Centre for Social Applications of Geographic Information Systems (GISCA).4 For example, Jenks’ (natural breaks) classification is used for all sociodemographic thematic mapping at GISCA. Overall, we identified only four CHF programs which were located in regional areas. Other rural programs were excluded as they did not meet our prespecified definition of a CHF program.

In summary, we acknowledge the need for better data to describe the burden of CHF throughout Australia. We also explicitly acknowledge the need for a less “metro-centric” approach to CHF service: perhaps by using remote monitoring techniques.5

Authors

  • Robyn A Clark1
  • Andrea Driscoll2
  • Justin Nottage3
  • Skye McLennan4
  • David M Coombe3
  • Errol J Bamford3
  • David Wilkinson5
  • Simon Stewart6
  • 1. Health Sciences Department, University of South Australia, Adelaide, SA.
  • 2. Faculty of Health Sciences, Deakin University, Melbourne, VIC.
  • 3. National Centre for Social Applications of Geographic Information Systems (GISCA), University of Adelaide, Adelaide, SA.
  • 4. Department of Psychology, University of Adelaide, Adelaide, SA.
  • 5. Mayne Medical School, University of Queensland, Brisbane, QLD.
  • 6. Preventative Cardiology Division, Baker Heart Research Institute, Melbourne, VIC.

Correspondence: robyn.clark@unisa.edu.au

References

View this article on Wiley Online Library