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Healthy Communities: GP care for patients with chronic conditions in 2009–2013 - Report - Key findings: GP care for patients with selected cardiovascular risk conditions

Healthy Communities: GP care for patients with chronic conditions in 2009–2013

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Key findings: GP care for patients with selected cardiovascular risk conditions

In Australia, many of the most common chronic conditions are cardiovascular risk conditions, including hyperlipidaemia (12%), type 2 diabetes (6%) and ischaemic heart disease (5%).13,14

Among all people who visit the GP at least once in a year, the percentage of people who had one or more selected cardiovascular risk conditions ranged from 17% to 19% in metropolitan communities to 16% to 21% in regional and rural communities (Figure 4).

The percentage of all GP consultations that involved patients who had a selected cardiovascular risk condition, irrespective of whether the condition was managed, was 22% in high and middle-income metropolitan areas compared to 19% to 30% in lower-income metropolitan, as well as all regional and rural areas (Figure 5).

GPs managed cardiovascular risk conditions in about one-third of all consultations with these patients. Across local areas, the proportion of all GP consultations in which cardiovascular risk conditions were actively managed ranged from one in nine (11%) consultations in Hume (Vic/NSW) to one in 20 (5%) consultations in South Eastern Melbourne and West Moreton-Oxley (Qld) (Figure 6b).

GP actions to manage selected cardiovascular risk conditions also varied across local areas, which illustrates the diverse approaches to managing these conditions and may reflect the availability of allied health professionals and specialists.

Depending on where a GP practises, the percentage of GP management occasions in which statins were prescribed ranged from 26% in South Eastern Melbourne and Sunshine Coast (Qld) to 40% in Central Queensland and Eastern Sydney.

Across local areas, a referral to another health professional was provided for one in 25 (4%) GP management occasions for a cardiovascular risk condition in Bayside (Vic), Northern Melbourne, and Central Queensland compared to one in nine (11%) occasions in Nepean-Blue Mountains (NSW) (Figure 7).

There were also some differences between similar local areas that are within the same peer group, after accounting for geographic and socioeconomic characteristics.

Selected cardiovascular risk conditions comprise ischaemic heart disease, including acute myocardial infarction (AMI), cerebrovascular disease, heart failure, stroke and hyperlipidaemia, and type 2 diabetes for people 60 years and over. These conditions were selected based on recommended guidelines for the management of these conditions.11
Figure 4: Percentage of people who visit the GP at least once in a year who had a selected cardiovascular risk condition*, by Medicare Local catchment peer group, 2005–2013

Peer groups Percentage of patients
Metro 1 18% (CI: 16%–20%)
Metro 2 17% (CI: 15%–19%)
Metro 3 19% (CI: 17%–21%)
Regional 1 18% (CI: 16%–20%)
Regional 2 21% (CI: 19%–22%)
Rural 1 21% (CI: 16%–26%)
Rural 2 16% (CI: 11%–20%)
Figure 5: Percentage of GP consultations with patients who had a selected cardiovascular risk condition*, by Medicare Local catchment peer group, 2005–2013

Peer groups Percentage of GP consultations
Metro 1 22% (CI: 20%–25%)
Metro 2 22% (CI: 20%–24%)
Metro 3 28% (CI: 25%–30%)
Regional 1 25% (CI: 23%–28%)
Regional 2 28% (CI: 25%–30%)
Rural 1 30% (CI: 24%–36%)
Rural 2 19% (CI: 15%–24%)
Figure 6a: Percentage of GP consultations in which a selected cardiovascular risk condition* was managed, by Medicare Local catchment peer group, 2009–2013

Peer groups Percentage of GP consultations
Metro 1 7% (CI: 7%–7%)
Metro 2 7% (CI: 7%–7%)
Metro 3 7% (CI: 7%–8%)
Regional 1 7% (CI: 7%–8%)
Regional 2 8% (CI: 8%–8%)
Rural 1 7% (CI: 6%–8%)
Rural 2 7% (CI: 6%–8%)
Figure 6b: Percentage of GP consultations in which a selected cardiovascular risk condition* was managed, by Medicare Local catchment, 2009–2013

Medicare Local catchments grouped by peer group Percentage of GP consultations
Metro 17% (CI: 7%–7%)
Inner NW Melbourne8% (CI: 6%–9%)
Inner West Sydney8% (CI: 6%–9%)
Northern Sydney7% (CI: 7%–8%)
Eastern Sydney7% (CI: 6%–8%)
Bayside (Vic)7% (CI: 6%–8%)
Inner East Melbourne7% (CI: 6%–8%)
Australian Capital Territory6% (CI: 5%–7%)
Sydney Nth Shore & Beaches6% (CI: 5%–7%)
Metro 27% (CI: 7%–7%)
Sthn Adelaide-Fleurieu-Kang. Is.9% (CI: 8%–11%)
South Western Melbourne9% (CI: 6%–12%)
Eastern Melbourne8% (CI: 6%–10%)
Perth Central & East Metro8% (CI: 7%–9%)
Fremantle (WA)8% (CI: 6%–9%)
Central Adelaide & Hills7% (CI: 6%–8%)
South Eastern Sydney7% (CI: 6%–8%)
Perth North Metro7% (CI: 6%–8%)
Greater Metro South Brisbane6% (CI: 6%–7%)
Bentley-Armadale (WA)6% (CI: 5%–7%)
Gold Coast (Qld)6% (CI: 5%–7%)
Metro North Brisbane6% (CI: 5%–7%)
Metro 37% (CI: 7%–8%)
Northern Melbourne9% (CI: 8%–11%)
Northern Adelaide9% (CI: 7%–10%)
South Western Sydney8% (CI: 7%–9%)
Macedon Ranges & NW Melbourne7% (CI: 6%–8%)
Western Sydney7% (CI: 6%–8%)
West Moreton-Oxley (Qld)5% (CI: 4%–6%)
South Eastern Melbourne5% (CI: 4%–6%)
Regional 17% (CI: 7%–8%)
Illawarra-Shoalhaven (NSW)9% (CI: 8%–11%)
Perth South Coastal8% (CI: 6%–10%)
Hunter (NSW)8% (CI: 7%–9%)
Frankston-Mornington Peninsula (Vic)8% (CI: 6%–9%)
Central Coast NSW8% (CI: 6%–9%)
Barwon (Vic)7% (CI: 5%–8%)
Nepean-Blue Mountains (NSW)6% (CI: 5%–7%)
Sunshine Coast (Qld)6% (CI: 5%–7%)
Regional 28% (CI: 8%–8%)
Hume (Vic/NSW)11% (CI: 9%–13%)
Murrumbidgee (NSW)10% (CI: 8%–13%)
Loddon-Mallee-Murray (Vic/NSW)9% (CI: 7%–11%)
Goulburn Valley (Vic)9% (CI: 6%–11%)
Gippsland (Vic)9% (CI: 7%–10%)
Wide Bay (Qld)8% (CI: 7%–10%)
Great South Coast (Vic)8% (CI: 7%–10%)
Darling Downs-SW Qld8% (CI: 7%–9%)
Southern NSW8% (CI: 7%–9%)
South West WA8% (CI: 6%–9%)
North Coast NSW7% (CI: 6%–8%)
Tasmania7% (CI: 6%–8%)
Western NSW7% (CI: 6%–8%)
Grampians (Vic)7% (CI: 6%–9%)
New England (NSW)6% (CI: 5%–7%)
Country South SANP
Rural 17% (CI: 6%–8%)
Central Qld8% (CI: 6%–11%)
Townsville-Mackay (Qld)7% (CI: 6%–8%)
Country North SA7% (CI: 5%–8%)
Far West NSWNP
Lower Murray (Vic/NSW)NP
Rural 27% (CI: 6%–8%)
Far North Qld7% (CI: 5%–8%)
Northern Territory6% (CI: 4%–8%)
Central & NW QldNP
Goldfields-Midwest (WA)NP
Kimberley-Pilbara (WA)NP

95% confidence interval.

* Selected cardiovascular risk conditions comprise ischaemic heart disease including acute myocardial infarction (AMI), cerebrovascular disease, heart failure, stroke and hyperlipidaemia, and type 2 diabetes for people 60 years and over. These conditions were selected based on recommended guidelines for the management of these conditions.

Customised analysis of BEACH SAND substudy data (2005–2013) weighted to the attending population using Department of Human Services, Medicare Benefits statistics, 12 months ending June 2013.

# Interpret with caution.

NP Not available for publication.

Notes: Data are reported as whole numbers. However, for graphical display and ordering they are plotted unrounded. Data are collected from a national survey of GPs. Characteristics of participating GPs may differ from non-participating GPs in a Medicare Local catchment which may affect the generalisability of results. For data limitations and exclusions see this report’s Technical Supplement.

Sources: Customised analysis of BEACH dataset (April 2009–March 2013) and BEACH SAND substudy dataset (July 2005–June 2013) prepared for the National Health Performance Authority by the Family Medicine Research Centre, the University of Sydney.

Data can be downloaded from Explore the data.

Figure 7: Percentage of GP management occasions in which statins were prescribed or a referral to a health professional was provided in the management of a selected cardiovascular risk condition*, by Medicare Local catchment, 2009–2013

Medicare Local catchments grouped by peer group Percentage of GP management occasions for selected cardiovascular risk conditions
Statins Referral
Metro 134% (CI: 32%–35%)8% (CI: 7%–8%)
Eastern Sydney40% (CI: 34%–45%)8% (CI: 5%–11%)
Sydney Nth Shore & Beaches38% (CI: 33%–43%)9% (CI: 7%–11%)
Inner East Melbourne34% (CI: 31%–38%)7% (CI: 5%–9%)
Northern Sydney34% (CI: 29%–40%)9% (CI: 7%–11%)
Australian Capital Territory34% (CI: 29%–39%)7% (CI: 4%–10%)
Inner West Sydney32% (CI: 28%–36%)8% (CI: 6%–10%)
Bayside (Vic)31% (CI: 27%–36%)4% (CI: 2%–6%)
Inner NW Melbourne28% (CI: 24%–33%)7% (CI: 5%–9%)
Metro 232% (CI: 31%–33%)7% (CI: 7%–8%)
Gold Coast (Qld)36% (CI: 31%–41%)8% (CI: 5%–10%)
Perth North Metro35% (CI: 30%–41%)6% (CI: 4%–9%)
Fremantle (WA)34%# (CI: 28%–40%)7%# (CI: 4%–9%)
Perth Central & East Metro33% (CI: 29%–37%)7% (CI: 5%–9%)
Metro North Brisbane33% (CI: 29%–36%)9% (CI: 6%–11%)
South Eastern Sydney32% (CI: 27%–37%)8% (CI: 5%–10%)
Greater Metro South Brisbane32% (CI: 28%–35%)7% (CI: 5%–8%)
Southern Adelaide-Fleurieu-Kang. Is.31% (CI: 26%–36%)7% (CI: 5%–9%)
Central Adelaide & Hills30% (CI: 26%–33%)7% (CI: 5%–9%)
Bentley-Armadale (WA)30%# (CI: 23%–36%)7%# (CI: 3%–11%)
Eastern Melbourne28% (CI: 21%–35%)8% (CI: 6%–9%)
South Western MelbourneNPNP
Metro 334% (CI: 32%–35%)8% (CI: 7%–8%)
Northern Adelaide38% (CI: 32%–45%)8% (CI: 5%–11%)
Western Sydney34% (CI: 31%–38%)8% (CI: 6%–10%)
Macedon Ranges & NW Melbourne34% (CI: 29%–40%)6% (CI: 4%–8%)
Northern Melbourne34% (CI: 28%–39%)4% (CI: 3%–6%)
South Western Sydney33% (CI: 29%–36%)9% (CI: 7%–10%)
West Moreton-Oxley (Qld)32%# (CI: 25%–38%)10%# (CI: 7%–13%)
South Eastern Melbourne26%# (CI: 20%–32%)6%# (CI: 3%–9%)
Regional 130% (CI: 28%–32%)9% (CI: 8%–10%)
Central Coast NSW34% (CI: 26%–41%)9% (CI: 6%–12%)
Frankston-Mornington Peninsula (Vic)32%# (CI: 24%–40%)10%# (CI: 6%–14%)
Barwon (Vic)32%# (CI: 25%–38%)7%# (CI: 4%–11%)
Illawarra-Shoalhaven (NSW)31% (CI: 26%–35%)9% (CI: 6%–12%)
Hunter (NSW)30% (CI: 27%–34%)9% (CI: 7%–11%)
Nepean-Blue Mountains (NSW)29%# (CI: 23%–35%)11%# (CI: 8%–14%)
Sunshine Coast (Qld)26% (CI: 21%–31%)8% (CI: 6%–11%)
Perth South CoastalNPNP
Regional 231% (CI: 30%–33%)8% (CI: 7%–8%)
Hume (Vic/NSW)39%# (CI: 31%–47%)7%# (CI: 5%–10%)
Tasmania36% (CI: 32%–40%)5% (CI: 3%–6%)
Southern NSW35% (CI: 30%–40%)6% (CI: 3%–9%)
South West WA32% (CI: 28%–36%)7% (CI: 5%–10%)
Wide Bay (Qld)30%# (CI: 24%–36%)5%# (CI: 2%–7%)
North Coast NSW29% (CI: 25%–34%)10% (CI: 7%–13%)
Western NSW28% (CI: 23%–34%)10% (CI: 6%–14%)
Gippsland (Vic)28% (CI: 24%–33%)7% (CI: 4%–10%)
Darling Downs-SW Qld27% (CI: 22%–31%)8% (CI: 5%–10%)
Country South SANPNP
Goulburn Valley (Vic)NPNP
Grampians (Vic)NPNP
Great South Coast (Vic)NPNP
Loddon-Mallee-Murray (Vic/NSW)NPNP
Murrumbidgee (NSW)NPNP
New England (NSW)NPNP
Rural 136% (CI: 31%–40%)6% (CI: 4%–8%)
Central Qld40%# (CI: 29%–51%)4%# (CI: 2%–6%)
Townsville-Mackay (Qld)36% (CI: 31%–41%)6% (CI: 3%–9%)
Country North SA32%# (CI: 25%–39%)8%# (CI: 5%–11%)
Far West NSWNPNP
Lower Murray (Vic/NSW)NPNP
Rural 232% (CI: 28%–36%)9% (CI: 6%–11%)
Far North Qld29% (CI: 24%–34%)10% (CI: 6%–13%)
Central & NW QldNPNP
Goldfields-Midwest (WA)NPNP
Kimberley-Pilbara (WA)NPNP
Northern TerritoryNPNP

95% confidence interval.

* Selected cardiovascular risk conditions comprise ischaemic heart disease including acute myocardial infarction (AMI), cerebrovascular disease, heart failure, stroke and hyperlipidaemia, and type 2 diabetes for people 60 years and over. These conditions were selected based on recommended guidelines for the management of these conditions.

# Interpret with caution.

NP Not available for publication.

Notes: Data are reported as whole numbers. However, for graphical display and ordering they are plotted unrounded. Data are collected from a national survey of GPs. Characteristics of participating GPs may differ from non-participating GPs in a Medicare Local catchment which may affect the generalisability of results. For data limitations and exclusions see this report’s Technical Supplement.

Sources: Customised analysis of BEACH dataset (April 2009–March 2013) and BEACH SAND substudy dataset (July 2005–June 2013) prepared for the National Health Performance Authority by the Family Medicine Research Centre, the University of Sydney.

Data can be downloaded from Explore the data.

GP management of selected cardiovascular risk conditions
Years of data: 2009–2013

During 2009–2013, the percentage of GP consultations in which a selected cardiovascular risk condition1 was managed varied across Medicare Local catchments and across peer groups, ranging from 11% in Hume (Vic/NSW) to 5% in South Eastern Melbourne and West Moreton-Oxley (Qld).

Percentage of GP consultations in which a selected cardiovascular risk condition was managed, 2009–2013

The following image is a map of Australia showing the percentage of GP consultations in which a selected cardiovascular risk condition was managed for mddicare local catchments. Data can be found in the Fair comparisons section.

Results for Medicare Local catchments were ranked from highest to lowest and then split into seven equal-sized groups.2

The following is a legend for the maps detailed on this page. The first row shows the various colour ranges, the second is the relevant colour's range value and the third indicates which end is highest and lowest.
NP
5.0%
6.0%
7.0%
8.0%
9.0%
10.0%
11.0%
Lowest group
Highest group
Medicare Local catchment boundary
506
Numbers on map are Medicare Local reference codes
The following are images of maps around major cities showing the percentage of GP consultations in which a selected cardiovascular risk condition was managed for mddicare local catchments. Data can be found in the Fair comparisons section.

i. Perth and
surrounding areas

ii. Adelaide and
surrounding areas

iii. Melbourne and
surrounding areas

iv. Canberra and
surrounding areas

v. Sydney and
surrounding areas

vi. Brisbane and
surrounding areas

1. Selected cardiovascular risk conditions comprise ischaemic heart disease including acute myocardial infarction (AMI), cerebrovascular disease, heart failure, stroke and hyperlipidaemia, and type 2 diabetes for people 60 years and over. These conditions were selected based on recommended guidelines for the management of these conditions.

2. Each Medicare Local catchment has been assigned to a group that represents one percentage point.

3. For more information on peer groups and the calculation of peer group results refer to this report’s Technical Supplement.

Notes: Data are reported as whole numbers. However, for graphical display and ordering they are plotted unrounded. Data are collected from a national survey of GPs. Characteristics of participating GPs may differ from non-participating GPs in a Medicare Local catchment which may affect the generalisability of results. For data limitations and exclusions see this report’s Technical Supplement.

Source: Customised analysis of BEACH data prepared for the National Health Performance Authority by the Family Medicine Research Centre, the University of Sydney, 2009–2013. Data can be downloaded from Explore the data.

Fair comparisons

To compare Medicare Locals more fairly, each Medicare Local catchment has been grouped into one of seven peer groups3, based on remoteness and socioeconomic status.
This allows:

  • Medicare Local catchments to be compared within the same metropolitan, regional or rural peer group
  • Medicare Local catchments to be compared with the average for their peer group.

It also allows variation to be seen across peer groups that may be associated with remoteness and socioeconomic status.

See the PDF ReportOpens in a new window. for a graphical representation of the table below.

Peer groups Map Ref. Percentage of GP Consultations
Metro 17% (CI: 7%–7%)
Inner NW Melbourne2018% (CI: 6%–9%)
Inner West Sydney1028% (CI: 6%–9%)
Northern Sydney1077% (CI: 7%–8%)
Eastern Sydney1017% (CI: 6%–8%)
Bayside2027% (CI: 6%–8%)
Inner East Melbourne2067% (CI: 6%–8%)
Australian Capital Territory8016% (CI: 5%–7%)
Sydney North Shore & Beaches1086% (CI: 5%–7%)
Metro 27% (CI: 7%–7%)
Sthn Adelaide-Fleurieu-Kang. Is.4039% (CI: 8%–11%)
South Western Melbourne2039% (CI: 6%–12%)
Eastern Melbourne2078% (CI: 6%–10%)
Perth Central & East Metro5018% (CI: 7%–9%)
Fremantle5038% (CI: 6%–9%)
Central Adelaide & Hills4027% (CI: 6%–8%)
South Eastern Sydney1037% (CI: 6%–8%)
Perth North Metro5027% (CI: 6%–8%)
Greater Metro South Brisbane3026% (CI: 6%–7%)
Bentley-Armadale5046% (CI: 5%–7%)
Gold Coast3036% (CI: 5%–7%)
Metro North Brisbane3016% (CI: 5%–7%)
Metro 37% (CI: 7%–8%)
Northern Melbourne2059% (CI: 8%–11%)
Northern Adelaide4019% (CI: 7%–10%)
South Western Sydney1048% (CI: 7%–9%)
Macedon Ranges & NW Melbourne2047% (CI: 6%–8%)
Western Sydney1057% (CI: 6%–8%)
West Moreton-Oxley3055% (CI: 4%–6%)
South Eastern Melbourne2085% (CI: 4%–6%)
Regional 17% (CI: 7%–8%)
Illawarra-Shoalhaven1109% (CI: 8%–11%)
Perth South Coastal5058% (CI: 6%–10%)
Hunter1118% (CI: 7%–9%)
Frankston-Mornington Peninsula2098% (CI: 6%–9%)
Central Coast NSW1098% (CI: 6%–9%)
Barwon2107% (CI: 5%–8%)
Nepean-Blue Mountains1066% (CI: 5%–7%)
Sunshine Coast3046% (CI: 5%–7%)
Regional 28% (CI: 8%–8%)
Hume21611% (CI: 9%–13%)
Murrumbidgee11610% (CI: 8%–13%)
Loddon-Mallee-Murray2149% (CI: 7%–11%)
Goulburn Valley2159% (CI: 6%–11%)
Gippsland2179% (CI: 7%–10%)
Wide Bay3078% (CI: 7%–10%)
Great South Coast2128% (CI: 7%–10%)
Darling Downs-SW Qld3068% (CI: 7%–9%)
Southern NSW1178% (CI: 7%–9%)
South West WA5068% (CI: 6%–9%)
North Coast NSW1137% (CI: 6%–8%)
Tasmania6017% (CI: 6%–8%)
Western NSW1157% (CI: 6%–8%)
Grampians2117% (CI: 6%–9%)
New England1146% (CI: 5%–7%)
Country South SA404NP
Rural 17% (CI: 6%–8%)
Central Qld3088% (CI: 6%–11%)
Townsville-Mackay3107% (CI: 6%–8%)
Country North SA4057% (CI: 5%–8%)
Far West NSW118NP
Lower Murray213NP
Rural 27% (CI: 6%–8%)
Far North Qld3117% (CI: 5%–8%)
Northern Territory7016% (CI: 4%–8%)
Central & NW Qld309NP
Goldfields-Midwest507NP
Kimberley-Pilbara508NP

11 National Health and Medical Research Council (NHMRC). Guidelines for the management of absolute cardiovascular disease risk [Internet]. NHMRC; 2012 [cited 2014 Oct 24]. Available from: https://www.nhmrc.gov.au/guidelines/publications/ext10

13 Australian Bureau of Statistics (ABS). Australian Health Survey [Internet]. Canberra: Commonwealth of Australia; 2012 Oct 10 [cited 2014 Oct 14]. Available from: http://www.abs.gov.au/australianhealthsurveyExternal link, opens in a new window.

14 Harrison CM, Britt HC, Miller GC, Henderson J. Prevalence of chronic conditions in Australia.PLoS ONE. 2013;8(7):e67494. DOI:10.1371/journal.pone.0067494.

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