Abstract
BackgroundOlder Australians are major health service users and early diagnosis is key in the management of their health. Radiological services are an important component of diagnosis and disease management planning in older Australians, but their national utilisation of diagnostic services has never been investigated in Australia.PurposeThis study aims to evaluate the utilisation of major plain X-rays by Australians ≥ 65 years old.MethodsA population-based epidemiological evaluation and yearly cross-sectional analyses of X-ray examinations per 1,000 Australians aged ≥ 65 years old between 2009 and 2019 were conducted using publicly available Medicare Benefits Schedule and Australian Bureau of Statistics data sources. Age and sex specific incidence rate (IR) of plain X-rays per 1,000 Australians, adjusted incidence rate ratios (IRR) and 95% confidence intervals (CI) were estimated using a negative binomial regression model.ResultsDuring the study period, the Australian population over 65 years old increased by 39% while the crude plain X-ray utilisation by this population increased by 63%. Most X-rays were conducted on extremities or the chest. Men used chest radiography more than women, and particularly for lungs, where the incidence increased the most in those ≥ 85 years old. There was an increase in X-rays of extremities and the hip joint between 2009–10 and 2013–14 in people ≥ 85 years old.ConclusionThe utilisation of plain X-rays of the chest, the gastro-intestinal tract and extremities was high and has increased among older Australians between 2009–10 and 2018–19. Plain X-rays remain a commonly used diagnostic tool for conditions affecting the older population.
Highlights
Older Australians are major health service users and early diagnosis is key in the management of their health
Total incidence of plain X‐rays for the indication of fall‐related injuries, pneumonia, heart failure and acute abdomen or bowel obstruction In 2018–19, 3,058,677 plain X-rays of the chest, gastrointestinal tract (GI) tract, extremities and the hip joint were conducted on patients ≥ 65 years old compared to 1,873,581 in 2009–10 (Fig. 1), representing a 63% increase in crude plain X-ray use
More of these X-rays were conducted on women than on men, with 53% of crude incidence recorded for women in 2018–19, which is consistent with population composition, where females accounted for 53% of the population ≥ 65 years old
Summary
Older Australians are major health service users and early diagnosis is key in the management of their health. Plain X-rays were the diagnostic imaging test ordered the most by general practitioners across all age categories before ultrasounds with a rate of 4.5 orders per 100 encounters and 2.7 orders per 100 encounters respectively [6]. These X-rays were mostly conducted for fall-related or skeletal issues and for acute bronchitis or bronchiolitis, conditions commonly experienced by the elder population [8,9,10,11,12]. While plain X-rays remain a staple for the diagnosis of conditions experienced by older citizens, little is known about the specific utilisation of this diagnostic imaging technique by older Australians
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