A 6-year audit of public-sector MR utilisation in the Western Cape province of South Africa

SA Journal of Radiology

Field Value
Title A 6-year audit of public-sector MR utilisation in the Western Cape province of South Africa
Creator Parak, Yusuf Davis, Razaan Barnard, Michelle Fernandez, Amanda Cloete, Keith Mukosi, Matodzi Pitcher, Richard D.
Subject Radiology; magnetic resonance imaging; utilization radiology; public sector; middle income country; magnetic resonance imaging (MRI); utilisation; equitable access; health equity
Description Background: Disparities in MR access between different countries and healthcare systems are well documented. Determinants of unequal access within the same healthcare system and geographical region are poorly understood.Objective: An analysis of public sector MR utilisation in South Africa’s Western Cape province (WCP).Methods: A retrospective study of WCP MR and population data for 2013 and 2018. MR units/106 people, studies, and studies/103 people were calculated for each year, for the whole province and the ‘western’ and ‘eastern’ referral pathways, stratified by age (0–14 years, 14 years)Results: Between 2013 and 2018, the WCP population increased 8% (4.63 vs 5.08 × 106 people) while MR resources were unchanged (‘western’ = 2 units; ‘eastern’ = 1), equating to decreasing access (units/106 people) for the province (0.65 vs 0.59; –9.2%), the ‘western’ (0.97 vs 0.9; –7.2%) and ‘eastern’ (0.39 vs 0.35; -10.3%) pathways. In 2013, 40% (4005/10 090) of studies were in the ‘eastern’ pathway serving 55% (2 066 079/4 629 051) of the population. Between 2013 and 2018 ‘eastern’ population growth (n = 286 781) exceeded ‘western’ (n = 168 469) by 70% (n = 118 312). By 2018, 38% (7939/12 848) of studies were performed in the ‘eastern’ pathway, then serving 56% (2 849 753/5 084 301) of the population. Among 0–14-year-olds, ‘western’ utilisation (studies/103 people) exceeded ‘eastern’ by a factor of approximately 2.4 throughout. In patients 14 years, the utilisation differential increased from 1.78 to 1.98 in the review period.Conclusion: Ensuring equitable services on the same healthcare platform requires ongoing surveillance of resource and population distribution. MR access can serve as a proxy for equity in highly specialised services.
Publisher AOSIS
Contributor Yusuf Parak Razaan Davis Michelle Barnard Amanda Fernandez Keith Cloete Matodzi Mukosi Richard D Pitcher
Date 2022-07-22
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Retrospective audit
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajr.v26i1.2464
Source South African Journal of Radiology; Vol 26, No 1 (2022); 6 pages 2078-6778 1027-202X
Language eng
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https://sajr.org.za/index.php/sajr/article/view/2464/3231 https://sajr.org.za/index.php/sajr/article/view/2464/3232 https://sajr.org.za/index.php/sajr/article/view/2464/3233 https://sajr.org.za/index.php/sajr/article/view/2464/3234 https://sajr.org.za/index.php/sajr/article/downloadSuppFile/2464/7223
Coverage Africa; South Africa; Western Cape 2013-2018 MRI investigations
Rights Copyright (c) 2022 Yusuf Parak, Razaan Davis, Michelle Barnard, Amanda Fernandez, Keith Cloete, Matodzi Mukosi, Richard D. Pitcher https://creativecommons.org/licenses/by/4.0