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


Wright, CM and Bulsara, MK and Norman, R and Moorin, R, Increase in computed tomography in Australia driven mainly by practice change: A decomposition analysis, Health Policy, 121, (7) pp. 823-829. ISSN 0168-8510 (2017) [Refereed Article]

Copyright Statement

© 2017 Elsevier B.V.

DOI: doi:10.1016/j.healthpol.2017.04.010


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.

Item Details

Item Type:Refereed Article
Keywords:Computed tomography Computed axial tomography CT scan Health service utilisation
Research Division:Health Sciences
Research Group:Epidemiology
Research Field:Epidemiology not elsewhere classified
Objective Division:Health
Objective Group:Public health (excl. specific population health)
Objective Field:Public health (excl. specific population health) not elsewhere classified
UTAS Author:Wright, CM (Mr Cameron Wright)
ID Code:121321
Year Published:2017
Web of Science® Times Cited:14
Deposited By:Medicine
Deposited On:2017-09-22
Last Modified:2018-09-11

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