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]
© 2017 Elsevier B.V.
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 Type:||Refereed Article|
|Keywords:||Computed tomography Computed axial tomography CT scan Health service utilisation|
|Research Division:||Health Sciences|
|Research Field:||Epidemiology not elsewhere classified|
|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)|
|Web of Science® Times Cited:||11|
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