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

Wright, CM, Bulsara, MK, Norman, R and Moorin, R 2017 , 'Increase in computed tomography in Australia driven mainly by practice change: A decomposition analysis' , Health Policy, vol. 121, no. 7 , 823–829 , doi: 10.1016/j.healthpol.2017.04.010.

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Background: Publicly funded computed tomography (CT) procedure descriptions inAustralia often specifythe body site, rather than indication for use. This study aimed to evaluate the relative contribution ofdemographic 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 attributableto changing population structure, CT use on a per capita basis (CPC, a proxy for change in practice) and/orcost of CT. Aggregated Medicare usage and billing data were obtained for selected years between 1993/4and 2012/3.Results: The number of billed CT scans rose from 33 per annum per 1000 of population in 1993/94 (total572,925) to 112 per 1000 by 2012/13 (total 2,540,546). The respective cost to Medicare rose from $145.7million to $790.7 million. Change in CPC was the most important factor accounting for changes in CTservices (88%) and cost (65%) over the study period.Conclusions: While this study cannot conclude if the increase is appropriate, it does represent a shift inhow CT is used, relative to when many CT services were listed for public funding. This ‘scope shift’ posesquestions as to need for and frequency of retrospective/ongoing review of publicly funded services, asmedical advances and other demand- or supply-side factors change the way health services are used.

Item Type: Article
Authors/Creators:Wright, CM and Bulsara, MK and Norman, R and Moorin, R
Keywords: Computed tomography Computed axial tomography CT scan Health service utilisation
Journal or Publication Title: Health Policy
Publisher: Elsevier Sci Ireland Ltd
ISSN: 0168-8510
DOI / ID Number: 10.1016/j.healthpol.2017.04.010
Copyright Information:

© 2017 Elsevier B.V.

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