Sources of funding for adult and paediatric CT procedures at a metropolitan tertiary hospital: How much do Medicare statistics really cover?
BACKGROUND
The radiation dose to the Australian paediatric population as a result of medical imaging is of growing concern, in particular the dose from CT. Estimates of the Australian population dose have largely relied on Medicare Australia statistics, which capture only a fraction of those imaging procedures actually performed. The fraction not captured has been estimated using a value obtained for a survey of the adult population in the mid-1990s. To better quantify the fraction of procedures that are not captured by Medicare Australia, procedure frequency and funding data for adult and paediatric patients were obtained from a metropolitan tertiary teaching and research hospital.


METHODS
Five calendar years of data were obtained with a financial class specified for each individual procedure. The financial classes were grouped to give the percentage of Medicare Australia billable procedures for both adult and paediatric patients. The data were also grouped to align with the Medicare Australia age cohorts.


RESULTS
The percentage of CT procedures billable to Medicare Australia increased from 16% to 28% between 2008 and 2012. In 2012, the percentage billable for adult and paediatric patients was 28% and 33%, respectively; however, many adult CT procedures are performed at stand-alone clinics, which bulk bill.


CONCLUSIONS
Using Medicare Australia statistics alone, the frequency of paediatric CT procedures performed on the Australian paediatric population will be grossly under estimated. A correction factor of 4.5 is suggested for paediatric procedures and 1.5 for adult procedures. The fraction of actual procedures performed that are captured by Medicare Australia will vary with time.
Medical Imaging Section, Australian Radiation Protection and Nuclear Safety Agency, Melbourne, Victoria, Australia.
Anna
A
Hayton
Medical Imaging Section, Australian Radiation Protection and Nuclear Safety Agency, Melbourne, Victoria, Australia.
Anthony
A
Wallace
Medical Imaging Section, Australian Radiation Protection and Nuclear Safety Agency, Melbourne, Victoria, Australia.
Peter
P
Johnston
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D017048:Health Care Costs / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019458:Insurance Coverage / Q000191:economics / Q000706:statistics & numerical data*; D008875:Middle Aged; D015233:Models, Statistical; D009313:National Health Programs / Q000191:economics* / Q000706:statistics & numerical data*; D062606:Tertiary Care Centers / Q000191:economics / Q000706:statistics & numerical data*; D014057:Tomography, X-Ray Computed / Q000191:economics* / Q000706:statistics & numerical data*; D014739:Victoria; D055815:Young Adult
Australian; Medicare; computed tomography; funding; paediatric; procedure frequency