Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia.
BMJ Open. 2021 Mar 19;11(3):e043304. doi: 10.1136/bmjopen-2020-043304.
Cardiovascular disease (CVD) represents a significant burden of disease for Aboriginal and Torres Strait Islander people, a population that continues to experience a lower life expectancy than other Australians. The aim of the Better Cardiac Care Data Linkage project is to describe patient care pathways and to identify disparities in care and health outcomes between Aboriginal and Torres Strait Islander people and other Queensland residents diagnosed with CVD in the state of Queensland.
This is a population-based retrospective cohort study using linked regional, state and national health and administrative data collections to describe disparities in CVD healthcare in primary and secondary prevention settings and during hospitalisation. The CVD cohort will be identified from the Queensland Hospital Admitted Patient Data Collection for admissions that occurred between 1 July 2010 and 31 June 2016 and will include relevant International Classification of Disease codes for ischaemic heart disease, congestive heart failure, stroke, acute rheumatic fever and rheumatic heart disease. Person-level data will be linked by Data Linkage Queensland and the Australian Institute of Health and Welfare (AIHW) in accordance with ethical and public health approvals to describe the patient journey prior to, during and post the hospital admission.
This project will focus largely on descriptive epidemiological measures and multivariate analysis of clinical care standards and outcomes for Aboriginal and Torres Strait Islander people compared with other Queenslanders, including identification of risk factors for suboptimal care and change over time. Variation in care pathways and patient outcomes will be compared by Indigenous status, sex, age group, remoteness of residence, year of index hospitalisation and socioeconomic status. Cox models for time-to-event data and mixed models or generalised estimating equations for longitudinal data will be used to measure change over time where temporal effects exist.
Ethical approval has been granted by Human Research Ethics Committees of the Prince Charles Hospital (HREC/15/QPCH/289) and the AIHW (EO2016-1-233). The Northern Territory Department of Health and Menzies School of Health Research have also provided reciprocal ethical approval of the project (HREC 2019-3490). The deidentified results will be summarised in a report and shared with investigators, advisory groups, Queensland Health and key stakeholders. Findings will be disseminated through workshops, conferences and will be published in peer-reviewed journals.
心血管疾病（CVD）是原住民和托雷斯海峡岛民的重大疾病负担，这一人群的预期寿命仍低于其他澳大利亚人。“改善心脏护理数据链接项目”的目的是描述患者的护理路径，并确定在昆士兰州诊断出 CVD 的原住民和托雷斯海峡岛民与其他昆士兰居民之间在护理和健康结果方面的差异。
这是一项基于人群的回顾性队列研究，使用区域、州和国家卫生及行政数据收集来描述初级和二级预防以及住院期间 CVD 医疗保健方面的差异。CVD 队列将从昆士兰州住院患者数据收集中确定，该数据将包括 2010 年 7 月 1 日至 2016 年 6 月 30 日期间的住院记录，并将包括缺血性心脏病、充血性心力衰竭、中风、急性风湿热和风湿性心脏病的相关国际疾病分类代码。将根据道德和公共卫生批准，由昆士兰数据链接和澳大利亚卫生和福利研究所（AIHW）对个人层面的数据进行链接，以描述住院前后的患者就医情况。
该项目将主要侧重于描述性流行病学措施以及对原住民和托雷斯海峡岛民与其他昆士兰人之间的临床护理标准和结果进行多变量分析，包括确定护理效果不佳的风险因素和随时间的变化。将根据土著身份、性别、年龄组、居住地点的偏远程度、索引住院年份和社会经济状况比较护理途径和患者结果的差异。将使用 Cox 模型进行时间事件数据的分析，以及使用混合模型或广义估计方程进行纵向数据的分析，以衡量随时间的变化。
该项目已获得查尔斯王子医院人类研究伦理委员会（HREC/15/QPCH/289）和澳大利亚卫生和福利研究所（EO2016-1-233）的伦理批准。北领地卫生部和梅恩兹斯健康研究学院也对该项目提供了互惠伦理批准（HREC 2019-3490）。将对结果进行汇总并以报告的形式提供给研究人员、咨询小组、昆士兰卫生厅和主要利益相关者。将通过研讨会、会议进行传播，并发表在同行评议的期刊上。
