Assessing utilisation of health technologies: coronary artery bypass graft surgery in New South Wales

The New South Wales health system aims to provide the most effective and efficient health care in a context of scarce resources and increasing availability of expensive technologies. The aging of the population and the management of chronic disease place further demands on the health system. Examination of the pattern of provision of services over time and between groups can serve to illustrate trends in clinical management practices which may affect other elements of the health system. In this paper we report an evaluation of the patterns of coronary artery bypass graft surgery (CABG) in New South Wales, within subgroups of the population and over time. The results demonstrate increased utilisation of this procedure in the population over recent years, particularly among the older age groups. We found differences in procedure rates between geographic areas which suggest that there are differences in the management of ischaemic heart disease between population subgroups. These patterns are examined in the context of the available literature on the health outcomes of CABG relative to other management options for ischaemic heart disease.