Heterogeneity of indigenous people and geography means that inferences about indigenous health are difficult to make. It appears that Victorian urban indigenous women have similar rates of preterm birth and LBW to nonindigenous women. While there were pleasing results concerning LBW, antenatal care, diabetes and preterm birth, the rates of smoking and obesity remain a challenge in the indigenous population.
At present the most significant concern for urologists during this pandemic is to safely mitigate the risk of SARS-CoV-2 infection of both patient and the surgical team by considering the immediate need of a particular procedure, the approach and indeed even ports used to access the abdomen along with managing the surgical plume and having appropriate PPE and adjusting their planning accordingly. "
Objectives
To assess the impact of the introduction of multiparametric magnetic resonance imaging of the prostate (mpMRIp) on the number of prostate biopsies performed in Australia.
Methods
Australian Medicare published statistics from 1 July 2007 to 30 June 2019 were obtained from publically available databases for prostate‐specific antigen (PSA) testing, prostate biopsy, and mpMRIp. Analysis was divided into three time periods broadly based on availability of mpMRI to the Australian public: 2007–2012 (no mpMRIp), 2012–2018 (mpMRIp available, privately funded), and 2018–2019 (mpMRIp available with Medicare funding). Introduction of mpMRIp was hypothesised to reduce the number of prostate biopsies performed. PSA testing numbers were used as a control. The economics model, proposed by the Medical Services Advisory Committee (MSAC), was analysed for cost savings.
Results
Accounting for variations in PSA testing, the introduction of mpMRIp from 2012 coincided with a reduction in the number of prostate biopsies by an average of 354.7/month (95% CI 175, 534.4; P < 0.001). Whilst the number of mpMRIp performed for the initial 12 months was underestimated by the MSAC at 38 470 vs 20 149 (+$8.3 million Australian dollars), we estimate the annual savings from reduced number biopsies and biopsy‐associated complications to be $13.2 ± 9.6 million.
Conclusion
Availability of mpMRIp in Australia has correlated with a significant reduction in prostate biopsy rates, with an estimated annual saving of $13.2 ± 9.6 million. Government funding of this diagnostic service has the potential to improve health equity and save on health expenditure.
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