The Utilization and National Variation of Plain X-Ray Services by Australian Residents of Long-Term Care Facilities.

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dc.contributor.authorInacio, M.C.
dc.contributor.authorJorissen, R.N.
dc.contributor.authorGaget, V.
dc.contributor.authorTivey, D.R.
dc.contributor.authorVisvanathan, R.
dc.contributor.authorMaddern, G.J.
dc.date.issued2022
dc.description.abstractOBJECTIVES: To (1) estimate incidence, trends, and determinants of government-subsidized diagnostic radiography (ie, plain x-ray) services utilization by Australian long-term care facility (LTCF) residents between 2009 and 2016; (2) examine national variation in services used. DESIGN: A repeated cross-sectional study. SETTING AND PARTICIPANTS: Australian LTCF residents who were ≥65 years old. METHODS: Medicare Benefits Schedule subsidized plain x-rays employed for diagnosing fall-related injuries, pneumonia, heart failure, and acute abdomen or bowel obstruction were identified. Yearly sex- and age-standardized utilization rates were calculated. Poisson and negative binomial regression models were employed. Facility-level variation was examined graphically. Overall and examination site-specific analyses were conducted. RESULTS: A total of 521,497 LTCF episodes for 453,996 individuals living in 3018 LTCFs were examined. The median age was 84 years (interquartile range 79-88), 65% (n = 339,116) were women, and 53.9% (n = 281,297) had dementia. In addition, 34.5% (n = 179,811) of episodes had at least one x-ray service. Overall, there was a 12% increase in utilization between 2009 and 2016 (from 535/1000 in 2009 to 602/1000 person-years in 2016, incidence rate ratio=1.02, 95% confidence interval 1.02-1.02). Factors associated with x-ray use included being 80-89 years old, being a man, not having dementia, having multiple health conditions (4-6 or ≥7 compared to 0-3), being at a smaller facility (0-24 bed compared to 50-74), facility located in the Australian state of New South Wales, or in major cities (compared to regional areas). National variation in x-ray service use, with largest differences observed by state, was detected. CONCLUSIONS AND IMPLICATIONS: Plain x-ray service utilization by LTCF residents increased 12% between 2009 and 2016. Sex, age, dementia status, having multiple health conditions as well as facility size, and location were associated with plain x-ray use in LTCFs and use varied geographically. Differences in x-ray service utilization by residents highlight lack of consistent access and potential over- or underutilization.
dc.description.statementofresponsibilityMaria C. Inacio, Robert N. Jorissen, Virginie Gaget, David R. Tivey, Renuka Visvanathan, Guy J. Maddern
dc.identifier.citationJournal of the American Medical Directors Association, 2022; 23(9):1564-1572
dc.identifier.doi10.1016/j.jamda.2022.05.004
dc.identifier.issn1525-8610
dc.identifier.issn1538-9375
dc.identifier.orcidGaget, V. [0000-0001-5331-8600]
dc.identifier.orcidTivey, D.R. [0000-0003-2213-2576]
dc.identifier.orcidVisvanathan, R. [0000-0002-1303-9479]
dc.identifier.orcidMaddern, G.J. [0000-0003-2064-181X]
dc.identifier.urihttps://hdl.handle.net/2440/137144
dc.language.isoen
dc.publisherElsevier BV
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/GNT119378
dc.rights© 2022 AMDA e The Society for Post-Acute and Long-Term Care Medicine.
dc.source.urihttps://doi.org/10.1016/j.jamda.2022.05.004
dc.subjectLong-term care facilities
dc.subjectx-ray services
dc.subjectolder adults
dc.subjecthealth services utilization
dc.subject.meshHumans
dc.subject.meshDementia
dc.subject.meshLong-Term Care
dc.subject.meshCross-Sectional Studies
dc.subject.meshX-Rays
dc.subject.meshAged
dc.subject.meshAged, 80 and over
dc.subject.meshNational Health Programs
dc.subject.meshAustralia
dc.subject.meshFemale
dc.subject.meshMale
dc.subject.meshMultimorbidity
dc.titleThe Utilization and National Variation of Plain X-Ray Services by Australian Residents of Long-Term Care Facilities.
dc.typeJournal article
pubs.publication-statusPublished

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