Utilisation of mobile X-ray services by residents of long-term care facilities

Access to mobile X-ray imaging (MXR) by long-term care facility (LTCF) residents could potentially reduce emergency department transfers. To encourage MXR use, the Australian Government Medicare Benefits Schedule introduced an MXR service subsidy in November 2019.

To examine the (i) MXR utilisation rate in LTCFs between 1 November 2019 and 30 June 2020; and (ii) individual and LTCF characteristics associated with accessing MXR compared to community-based X-rays.

A cross-sectional study of non-indigenous LTCF residents, ≥65 years old, between 1 November 2019 and 30 June 2020 in five geographical regions was conducted. Access to mobile and community-based X-rays was the outcome of interest. Descriptive statistics and monthly sex- and age-standardised utilisation rates were employed. Characteristics associated with the X-ray type accessed were estimated using generalised estimating equation logistic regression models.

149 389 LTCF episodes, by 127 002 individuals, in 1449 facilities were studied. The median age of the studied individuals was 85 years (interquartile range 79-90) and 63.4% (n = 94 692) were women. There were 5458 (3.7%) episodes that accessed an MXR service. MXR usage increased 75%, from 6.6/1000 (95% confidence interval (CI) 6.1-7.2) to 11.6/1000 (95% CI 10.9-12.3) person-months over the study period. Compared to community-based X-ray recipients, MXR recipients were older, more likely to have dementia, but less likely to have a higher number of health conditions, be in transition or respite care, be in a not-for-profit LTCF and be outside a major city.

A small but increasing use of government-subsidised MXR services was observed. Individuals accessing MXRs are those that likely benefit most from them. LTCF differences in service utilisation indicate gaps in service access.