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Increase in computed tomography in Australia driven mainly by practice change: A decomposition analysis

journal contribution
posted on 2023-05-19, 11:20 authored by Cameron Wright, Bulsara, MK, Norman, R, Moorin, R

Background: Publicly funded computed tomography (CT) procedure descriptions inAustralia often specify the body site, rather than indication for use. This study aimed to evaluate the relative contribution of demographic versus non-demographic factors in driving the increase in CT services in Australia.

Methods: A decomposition analysis was conducted to assess the proportion of additional CT attributable to changing population structure, CT use on a per capita basis (CPC, a proxy for change in practice) and/or cost of CT. Aggregated Medicare usage and billing data were obtained for selected years between 1993/4 and 2012/3.

Results: The number of billed CT scans rose from 33 per annum per 1000 of population in 1993/94 (total 572,925) to 112 per 1000 by 2012/13 (total 2,540,546). The respective cost to Medicare rose from $145.7 million to $790.7 million. Change in CPC was the most important factor accounting for changes in CT services (88%) and cost (65%) over the study period.

Conclusions: While this study cannot conclude if the increase is appropriate, it does represent a shift in how CT is used, relative to when many CT services were listed for public funding. This ‘scope shift’ poses questions as to need for and frequency of retrospective/ongoing review of publicly funded services, as medical advances and other demand- or supply-side factors change the way health services are used.

History

Publication title

Health Policy

Volume

121

Issue

7

Pagination

823-829

ISSN

0168-8510

Department/School

Tasmanian School of Medicine

Publisher

Elsevier Sci Ireland Ltd

Place of publication

Ireland

Rights statement

© 2017 Elsevier B.V.

Repository Status

  • Restricted

Socio-economic Objectives

Public health (excl. specific population health) not elsewhere classified

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