Inacio Maria C, Jorissen Robert N, Gaget Virginie, Tivey David R, Dollard Joanne, Visvanathan Renuka, Maddern Guy J
Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
Allied Health and Human Performance Academic Unit, University of South Australia, Adelaide, South Australia, Australia.
Intern Med J. 2025 Jun;55(6):951-958. doi: 10.1111/imj.70034. Epub 2025 Mar 24.
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.
长期护理机构（LTCF）的居民能够使用移动X射线成像（MXR）可能会减少急诊科转诊。为鼓励使用MXR，澳大利亚政府医疗保险福利计划于2019年11月推出了MXR服务补贴。
研究（i）2019年11月1日至2020年6月30日期间LTCF中MXR的使用率；以及（ii）与基于社区的X射线相比，使用MXR的个体和LTCF特征。
对2019年11月1日至2020年6月30日期间五个地理区域内年龄≥65岁的非原住民LTCF居民进行了一项横断面研究。使用移动和基于社区的X射线是研究的关注结果。采用描述性统计和每月性别和年龄标准化使用率。使用广义估计方程逻辑回归模型估计与所使用的X射线类型相关的特征。
研究了1449个机构中127002名个体的149389次LTCF事件。研究个体的中位年龄为85岁（四分位间距79 - 90），63.4%（n = 94692）为女性。有5458次（3.7%）事件使用了MXR服务。在研究期间，MXR的使用量增加了75%，从每千人月6.6次（95%置信区间（CI）6.1 - 7.2）增加到每千人月11.6次（95%CI 10.9 - 12.3）。与基于社区的X射线使用者相比，MXR使用者年龄更大，更有可能患有痴呆症，但健康状况较多、处于过渡或临时护理状态、在非营利性LTCF中以及在大城市以外的可能性较小。
观察到政府补贴的MXR服务使用量虽少但在增加。使用MXR的个体是那些可能从中受益最大的人。LTCF在服务利用方面的差异表明服务获取存在差距。
