title: Evaluation of a mobile X-ray service for elderly residents of residential aged care facilities.
abstract: OBJECTIVE
  The Royal Melbourne Hospital established a mobile X-ray service (MXS) in 2013. The goal of the MXS is to address the radiology needs of frail, elderly or demented residents of residential aged care facilities (RACFs) who would otherwise require transportation to attend for X-ray. The present study describes the activity of the MXS, and the impact of the MXS on emergency department (ED) attendances by residents of RACFs.
  
  
  METHODS
  The study is a descriptive study and uses a before-and-after cohort approach. Activity for the first year of operation was collected and described. At the end of the first year of operation, the top 30 RACF users of the MXS were identified. The hospital Department of Radiology database was examined to find all plain X-rays performed on any patient presenting from the same 30 RACFs for the 1 year before commencement of the MXS (1 July 2012-30 June 2013) and for the 1 year period after the commencement of the MXS (1 July 2013-30 June 2014). Attendances were compared.
  
  
  RESULTS
  The MXS delivered 1532 service attendances to 109 different RACFs. The mean age of patients receiving MXS services was 86 years (range 16-107 years). In all, 1124 services (73.4%) were delivered to patients in high-care RACFs. Most patients (n = 634; 41.4%) were bed or wheelchair bound, followed by those who required assistance to ambulate (n = 457; 29.8%). The most common X-ray examinations performed were chest, hip and pelvis, spine and abdomen. There were 919 service attendances to the top 30 RACFs using the MXS (60.0% of all attendances). There was an 11.5% reduction in ED presentations requiring plain X-ray in the year following the commencement of the MXS (95% confidence interval 0.62-3.98; P = 0.019).
  
  
  CONCLUSIONS
  The present study suggests a reduction in hospital ED attendances for high users of the MXS. This has benefits for hospitals, patients and nursing homes. It also allows the extension of other programs designed to treat patients in their RACFs. Special rebates for home-based radiology service provision should be considered.
authors.affiliation: Hospital in the Home, Royal Melbourne Hospital, Grattan Street, Parkville, Vic. 3050, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Montalto
authors.affiliation: Aged Care Imaging, 63A Clyde Street, Thornbury, Vic. 3071, Australia. Email.
authors.forename: Simon
authors.initials: S
authors.lastname: Shay
authors.affiliation: Department of Radiology, Royal Melbourne Hospital, Grattan Street, Parkville, Vic. 3050, Australia. Email.
authors.forename: Andy
authors.initials: A
authors.lastname: Le
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D003954:Diagnostic Services; D006707:Homes for the Aged; D006801:Humans; D008952:Mobile Health Units; D014739:Victoria; D014965:X-Rays