Clinical outcomes and health care costs of transferring rural Western Australians for invasive coronary angiography, and a cost-effective alternative care model

WA is a big state and equity in health care will remain an aspiration because people in Perth can be surrounded by family and friends when in hospital, while those referred from distant places must bear separation. Considering this, the proposal by Alexander and colleagues1 that CTCA be available in rural centres to avoid referral to Perth is worthwhile.1 However, patients who will not benefit from surgical intervention should still have equitable access to specialist consultation based on need. Telehealth could provide access, but it will be important to offer choice and monitor equity of both access and outcomes.