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The transition from hospital to primary care for patients with acute coronary syndrome: insights from registry data

In Australia, acute coronary syndrome (ACS) accounts for about 75 000 hospital separations annually, and in 2010 cost more than $8 billion.1 Those who survive are at high risk of recurrent events; in 2010, more than 25 000 Australian hospital separations were associated with repeat ACS2,3 at a cost of more than $600 million (direct costs only).1 Between 2000–01 and 2008–09, the largest expenditure increase, by health care sector, was for hospital-admitted patient services, where cardiovascular disease expenditure increased by 55%, from $2907 million to $4518 million.4 A recent report projected that by 2020 there will be around 102 363 separations associated with ACS in Australia, and about half of these will be due to repeat events.1 These statistics highlight the growing importance of secondary prevention as more people survive initial events. Further, it underscores the need for a health system that has an inbuilt process for commencing prevention during acute admissions, and the need to ensure an effective transition from hospital to primary care.

Favourable modification of coronary risk factors is responsible for at least a 50% reduction in mortality from cardiovascular disease.5