Higher costs to put the squeeze on emergency departments

By CHRISTIANE BARRO

Federal cuts to diagnostic imaging will see an influx of 300,000 additional patients into emergency departments, according to the Australian Diagnostic Imaging Association.

Diagnostic imaging includes services such as X-rays, CT scans, MRI scans and ultrasounds.

FromJuly 1, bulk-billing for these services will no longer apply to non-concession cardholders over the age of 16.

In attempts to avoid paying upfront fees for their imaging service, the imaging association predicts many patients will seek care in emergency departments and avoid referral from their GP.

“Waiting times will increase and inevitably some resources will be directed away from patients who need them the most,” the association's senior policy adviser Chris Kane said.

The Health Science Journal found, in a study published in 2015, that overcrowded emergency departments resulted in more medication errors, including giving medications in incorrect doses, frequencies, durations or using medications that might be harmful to the patient.

Australasian College for Emergency Medicine immediate past-president Dr Anthony Cross said medication administration error was a worrying factor in health care systems.

“Any staff member performing under increased time pressure or increased demands on their work is going to be more prone to error,” he said.

The imaging association has voiced concerns about patients who might delay treatment or even disregard having the service because of the cost, inevitably missing out on early diagnosis.

“They’ll be much sicker before they are treated. This means they will need more complex treatment and will spend longer in hospital, which will cost our health system much more than it does to have imaging services early,” Mr Kane said.

Patient Alison Richardson is regularly recommended for soft tissue scans by her GP. “Doctors over-prescribe imaging based on a fear of litigation these days,” she said.

Ms Richardson said she believed it was up to the patient to decide whether or not to pursue the referral.

“My last doctor's visit, she [my GP] suggested diagnostic testing which I researched, and decided was unnecessary based on previous tests I had. The total cost for her overly cautious nature was about $1000,” Ms Richardson said.

General patients receiving ultrasounds will face upfront costs of $117-$206.

As a patient who has health issues that require multiple ultrasounds, Madison Dyker said she would have no choice but to revert to emergency departments for scans.

Ms Dyker said in her case scans had been an imperative factor in early diagnosis.

“I had a massive gallstone that would have gone undiagnosed without bulk-billed ultrasounds, and I'm also in the process of probably getting diagnosed with endometriosis that have required multiple ultrasounds over the years,” she said.

The imaging association also estimates CT scanning used to detect the narrowing or blockage of coronary arteries, which can cause a heart attack, will cost patients upfront fees of $665 to $766.

Although it “doesn’t make sense” that people who could be cared for by their GP are instead cared for in the emergency department, Dr Cross said anything that made it difficult for patients to receive care from their GP  pushed people towards emergency departments as a “back-up strategy”.