Utilisation of mobile X-ray services by residents of long-term care facilities

Background: 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. 

Aims: 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. 

Methods: 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. 

Results: 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. 

Conclusions: 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.