Current and projected burden of heart failure in the Australian adult population: a substantive but still ill-defined major health issue

Abstract

Background: Comprehensive epidemiological data to describe the burden of heart failure (HF) in Australia remain lacking despite its importance as a major health issue. Herewith, we estimate the current and future burden of HF in Australia using best available data.

Methods: Australian-specific and the most congruent international epidemiological and health utilisation data were applied to the Australian population (adults aged ≥ 45 years, 8.9 of 22.7 million total population in 2014) on an age and sex-specific basis. We estimated the current incident and prevalent cases of clinically overt/symptomatic HF (predominately those with reduced ejection fraction), hospital activity (diagnosis of HF as a primary or secondary reason for admission) and health care costs in 2014 and future prevalence and burden of HF projected to 2030.

Results: We estimated that over 61,000 (6.9 per 1000 person-years) adult Australians aged ≥ 45 years (58 % women) are diagnosed with HF with clinically overt signs and symptoms every year. On a conservative basis, 480,000 (6.3 %, 95 % CI 2.6 to 10.0 %) Australians (66 % men) are now affected by the syndrome with > 150,000 hospitalisations in excess of 1 million days in hospital per annum. The annual cost of managing HF in the community is approximately $900 million and nearly $2.7 billion ($1.5 versus $1.2 billion, men versus women) when considering the additional cost of in-patient care. We predict that the prevalence and future burden of HF will continue to increase over the next 10-15 years to nearly 750,000 people with an estimated annual health care cost of $3.8 billion.

Conclusions: Australia is not immune to the growing magnitude and implications of a sustained epidemic of HF in an ageing population. However, its public health and economic burden will remain ill-defined until more definitive Australian-specific data are generated.

Keywords: Economic burden; Heart failure; Incidence; Prevalence.

Fig. 1

Incident and prevalent cases of heart failure with reduced ejection fraction (HFrEF) in the Australian population according to State and Territory

Fig. 2

Estimated current direct health care cost of clinically overt heart failure according to sex and type of care

Fig. 3

Current and projected estimations of a incident heart failure-related admissions and b overall prevalent cases of heart failure with reduced ejection fraction (HFrEF) from 2014 to 2030 according to sex and age categories

Fig. 4

Prevalent cases of heart failure associated with a reduced ejection fraction (HFrEF) and b preserved ejection fraction (HFpEF) in Australians aged ≥ 45 years according to age categories