Brown L F, Monsour P
School of Dentistry, The University of Queensland, Brisbane.
Aust Dent J. 2015 Dec;60(4):511-9. doi: 10.1111/adj.12250.
There is a lack of objective data documenting the growth of cone beam radiology in Australia. Medicare rebates for cone beam computed tomography (CBCT) scans have been available since 1 July 2011. The aim of this study was to examine the Medicare data on the use of CBCT in order to quantify the growth of this technology over a three-year period and to assess if the growth of CBCT was impacting upon the use of dental panoramic radiology.
The Medicare dataset was accessed, and data relating to the number and distribution of CBCTs and panoramic radiographs (PRs) were extracted. The data were broken down by state and territory, as well as by age group and gender of the patient, for the financial year periods July 2011 to June 2012, July 2012 to June 2013 and July 2013 to June 2014. Items relating to PRs were also extracted for the periods 2005-2008 and 2008-2011.
In the period July 2011 to June 2014, a total of 226 232 CBCTs and 2 881 351 PRs were rebated through Medicare. The rate of CBCT services provided per 100 000 population increased by 42.3% over the three-year period, whereas the rate of PRs remained fairly constant. From the age group 5-14 years through to 55-64 years, females received more CBCTs and PRs than males. The total number of PRs rebated through Medicare increased slightly over each previous three-year period (2005-2008 and 2008-2011).
There has been rapid growth of the use of CBCT over a three-year period, most marked in the State of Victoria. The higher number of CBCT examinations in females across almost all age groups, but most notably in the 15-24 years age group, raises questions about clinical decision making in the selection of cone beam imaging. There was little evidence that CBCTs were being used as a substitute for PRs, except for a small but consistent drop in the number of PRs being requested for diagnosis of surgically related dental conditions.
澳大利亚缺乏记录锥形束放射学发展情况的客观数据。自2011年7月1日起，医疗保险开始为锥形束计算机断层扫描（CBCT）提供回扣。本研究的目的是研究医疗保险中关于CBCT使用的数据，以量化该技术在三年期间的增长情况，并评估CBCT的增长是否对牙科全景放射学的使用产生影响。
获取医疗保险数据集，并提取与CBCT和全景X线片（PR）的数量及分布相关的数据。数据按州和领地以及患者的年龄组和性别进行分类，涵盖2011年7月至2012年6月、2012年7月至2013年6月以及2013年7月至2014年6月的财政年度。还提取了2005 - 2008年和2008 - 2011年期间与PR相关的项目。
在2011年7月至2014年6月期间，通过医疗保险获得回扣的CBCT总数为226232例，PR为2881351例。每10万人口中提供的CBCT服务率在三年期间增长了42.3%，而PR的比率保持相当稳定。从5 - 14岁年龄组到55 - 64岁年龄组，女性接受的CBCT和PR比男性更多。通过医疗保险获得回扣的PR总数在之前的每个三年期间（2005 - 2008年和2008 - 2011年）略有增加。
在三年期间，CBCT的使用迅速增长，在维多利亚州最为显著。几乎所有年龄组的女性接受CBCT检查的数量都更多，尤其是在15 - 24岁年龄组，这引发了关于锥形束成像选择中临床决策的问题。几乎没有证据表明CBCT被用作PR的替代品，除了在诊断与手术相关的牙科疾病时，请求PR的数量出现了小幅但持续的下降。
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