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Increase in computed tomography in Australia driven mainly by practice change: A decomposition analysis.
Cameron M Wright1, Max K Bulsara2, Richard Norman3
1Health Systems and Health Economics, School of Public Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia; Division of Pharmacy, School of Medicine, Faculty of Health, University of Tasmania, Hobart, Tasmania, Australia.
Health Policy (Amsterdam, Netherlands)
|May 29, 2017
Summary
The use of computed tomography (CT) services in Australia increased significantly, driven primarily by changes in medical practice rather than population growth. This shift in CT utilization warrants a review of publicly funded services.
Area of Science:
- Health Services Research
- Radiology
- Health Economics
Background:
- Publicly funded computed tomography (CT) procedures in Australia often list body sites, not indications.
- This study investigates demographic vs. non-demographic factors driving increased CT service utilization.
Purpose of the Study:
- To evaluate the relative contribution of demographic and non-demographic factors to the rise in Australian CT services.
- To analyze changes in CT utilization patterns over time.
Main Methods:
- Decomposition analysis of aggregated Medicare data (1993/4–2012/13).
- Assessed CT use per capita (CPC) as a proxy for practice change.
- Examined population structure and CT costs.
Main Results:
- Billed CT scans increased from 33 to 112 per 1000 population annually.
- Medicare costs for CT rose from $145.7M to $790.7M.
- Changes in CPC accounted for 88% of service increase and 65% of cost increase.
Conclusions:
- The rise in CT services reflects a 'scope shift' in utilization, not solely population changes.
- This necessitates reviewing the appropriateness and frequency of public funding for CT services.
- Medical advances and other factors influence evolving health service use.
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