Primary care physicians' access to in-house ultrasound examinations across Europe: a questionnaire study.

Aakjær Andersen, Camilla; Jensen, Martin Bach B; Toftegaard, Berit Skjødeberg; Vedsted, Peter; Harris, Michael (2019). Primary care physicians' access to in-house ultrasound examinations across Europe: a questionnaire study. BMJ open, 9(9), e030958. BMJ Publishing Group 10.1136/bmjopen-2019-030958

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OBJECTIVE

The overall objective of this study was to examine the differences in ultrasound availability in primary care across Europe.

DESIGN

Cross-sectional study.

SETTING

Primary care.

PARTICIPANTS

Primary care physicians (PCPs).

PRIMARY AND SECONDARY OUTCOMES MEASURES

The primary aim was to describe the variation in in-house primary care ultrasonography availability across Europe using descriptive statistics. The secondary aim was to explore associations between in-house ultrasonography availability and the characteristics of PCPs and their clinics using a mixed-effects logistic regression model.

RESULTS

We collected data from 20 European countries. A total of 2086 PCPs participated, varying from 59 to 446 PCPs per country. The median response rate per country was 24.8%. The median (minimum-maximum) percentage of PCPs across Europe with access to in-house abdominal ultrasonography was 15.3% (0.0%-98.1%) and 12.1% (0.0%-30.8%) had access to in-house pelvic ultrasonography with large variations between countries. We found associations between in-house abdominal ultrasonography availability and larger clinics (OR 2.5, 95% CI 1.2 to 4.9) and clinics with medical doctors specialised in areas, which traditionally use ultrasonography (OR 2.1, 95% CI 1.1 to 3.8). Corresponding associations were found between in-house pelvic ultrasonography availability and larger clinics (OR 1.9, 95% CI 1.3 to 2.7) and clinics with medical doctors specialised in areas, which traditionally use ultrasonography (OR 3.0, 95% CI 1.8 to 5.1). Additionally, we found a negative association between urban clinics and in-house pelvic ultrasound availability (OR 0.5, 95% CI 0.2 to 0.9).

CONCLUSIONS

Across Europe, there is a large variation in PCPs' access to in-house ultrasonography and organisational aspects of primary care seem to determine this variation. If evidence continues to support ultrasonography as a front-line point-of-care test, implementation strategies for increasing its availability in primary care are needed. Future research should focus on facilitators and barriers that may affect the implementation process.

Interest & Impact

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5 Citations in Web of Science ®
6 Citations in Scopus

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