Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.
Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia.
Australas J Ageing. 2023 Dec;42(4):710-719. doi: 10.1111/ajag.13228. Epub 2023 Jul 30.
To describe the economic and cost considerations of mobile X-ray services (MXS) in residential aged care facilities (RACFs), according to stakeholders (involved in residents' healthcare), residents living in RACFs and informal carers (ICs) of residents.
Semistructured interviews were conducted with 20 residents and 27 ICs recruited from six RACFs across metropolitan Adelaide (South Australia, Australia), and 22 stakeholders, on their perspectives of using MXS in RACFs. Data relating to economic and cost considerations were extracted and analysed using thematic analysis.
Residents' mean age was 85 years, 60% were women and 40% had experienced an MXS in the last 12 months. Most ICs were daughters (70%) and wives (11%) and 30% had a family member who had experienced an MXS in the last 12 months. Stakeholders included RACF staff, GPs, a hospital avoidance program clinician, paramedics, emergency department clinicians, MXS radiographers and manager, and a radiologist. Four themes were presented: (1) business considerations, where private providers found it necessary to charge residents a co-payment to deliver MXS; (2) cost and payment process as a potential barrier to using MXS, with varied willingness and ability to pay for an MXS co-payment, and equity concerns; (3) overcoming cost and payment barriers, with staff and consumers sometimes using strategies to overcome cost barriers; and (4) perceived cost benefits of MXS to the healthcare system, residents and ICs.
Mobile X-ray services providers charge residents an upfront co-payment for business viability, which can be a barrier to some residents wishing to access MXS.
根据利益相关者（参与居民医疗保健的人员）、居住在养老院的居民和居民的非正式照顾者（ICs）的观点，描述移动 X 光服务（MXS）在养老院中的经济和成本考虑因素。
从澳大利亚阿德莱德大都市区的六家养老院中招募了 20 名居民和 27 名 ICs 以及 22 名利益相关者，对他们在养老院中使用 MXS 的观点进行了半结构化访谈。提取并使用主题分析方法分析与经济和成本考虑相关的数据。
居民的平均年龄为 85 岁，60%为女性，40%在过去 12 个月内接受过 MXS。大多数 ICs 是女儿（70%）和妻子（11%），30%的人有在过去 12 个月内经历过 MXS 的家庭成员。利益相关者包括养老院工作人员、全科医生、医院回避计划临床医生、护理人员、急诊部临床医生、MXS 放射技师和经理以及放射科医生。呈现了四个主题：（1）商业考虑因素，私人供应商认为向居民收取 MXS 共付额是必要的；（2）成本和支付过程是使用 MXS 的潜在障碍，对 MXS 共付额的支付意愿和能力各不相同，存在公平性问题；（3）克服成本和支付障碍，工作人员和消费者有时会使用策略来克服成本障碍；（4）MXS 对医疗保健系统、居民和 ICs 的感知成本效益。
移动 X 光服务提供商为了业务可行性向居民收取预付款共付额，这可能成为一些希望获得 MXS 的居民的障碍。
