Consultant Cardiologist, Senior Lecturer Flinders University, Royal Darwin Hospital, Rocklands Drive, Tiwi, PO Box 41326, Casuarina NT 0811.
Senior Research Fellow, Flinders Human Behaviour and Health Research Unit, Flinders University, GPO Box 2100 Adelaide SA 5001.
Heart Lung Circ. 2014 May;23(5):391-406. doi: 10.1016/j.hlc.2013.12.005. Epub 2013 Dec 17.
The Northern Territory of Australia is a vast area serviced by two major tertiary hospitals. It has both a unique demography and geography, which pose challenges for delivering optimal heart failure services. The prevalence of congestive heart failure continues to increase, imposing a significant burden on health infrastructure and health care costs. Specific patient groups suffer disproportionately from increased disease severity or service related issues often represented as a "health care gap". The syndrome itself is characterised by ongoing symptoms interspersed with acute decompensation requiring lifelong therapy and is rarely reversible. For the individual client the overwhelming attention to heart failure care and the impact of health care gaps can be devastating. This gap may also contribute to widening socio-economic differentials for families and communities as they seek to take on some of the care responsibilities. This review explores the challenges of heart failure best practice in the Northern Territory and the opportunities to improve on service delivery. The discussions highlighted could have implications for health service delivery throughout regional centres in Australia and health systems in other countries.
澳大利亚的北领地由两家主要的三级医院提供服务。这里有着独特的人口统计学和地理环境，这给提供最佳心力衰竭服务带来了挑战。充血性心力衰竭的患病率持续上升，给卫生基础设施和医疗保健成本带来了巨大负担。特定的患者群体因疾病严重程度增加或与服务相关的问题而遭受不成比例的痛苦，这些问题通常表现为“医疗保健差距”。心力衰竭的特点是持续存在的症状，伴有需要终身治疗的急性失代偿，且很少能逆转。对于个人患者来说，对心力衰竭护理的过度关注以及医疗保健差距的影响可能是毁灭性的。这种差距也可能导致家庭和社区在承担一些护理责任时，扩大社会经济差异。本综述探讨了在北领地实施心力衰竭最佳实践的挑战，以及改善服务提供的机会。讨论强调的问题可能对澳大利亚各地区中心的医疗服务提供以及其他国家的医疗体系产生影响。
