Interventional gastroenterology

Atlas reveals wide variation in colonoscopy rates

Wide variations in rates of medical and surgical interventions have been revealed in the first Australian Atlas of Healthcare Variation.

The Atlas published by the Australian Commission on Safety and Quality in Health Care gives a clear picture of substantial variation in healthcare use across areas such as antibiotic prescribing, surgical, mental health and diagnostic services.

“Some variation is expected and associated with need-related factors… however, the weight of evidence in Australia and internationally suggests that much of the variation documented in the atlas is likely to be unwarranted,” the report said.

Figures showed that almost 600,000 MBS funded fibre optic colonoscopies were performed in Australia in 2013–14.

This number was likely to increase as the National Bowel Cancer Screening Program increases its coverage, the report noted.

Very large variations were seen in colonoscopy rates across the country – the highest rate was 30 times that of the lowest.

Even when highest and lowest rates were removed, the rate was more than four times higher in one local area compared with another.

Rates were higher in high socioeconomic populations in metropolitan areas and decreased with distance from major cities.

The report recommended the MBS review Taskforce reviews and realigns reimbursement with adherence to existing NHMRC clinical practice guidelines for surveillance colonoscopy

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