TY - JOUR
T1 - Primary care physicians' access to in-house ultrasound examinations across Europe
T2 - a questionnaire study
AU - Aakjær Andersen, Camilla
AU - Jensen, Martin Bach B
AU - Toftegaard, Berit Skjødeberg
AU - Vedsted, Peter
AU - Harris, Michael
AU - Örenäs Research group
PY - 2019/9
Y1 - 2019/9
N2 - 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.
AB - 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.
KW - diagnostic radiology
KW - organisation of health services
KW - primary care
KW - ultrasound
UR - http://www.scopus.com/inward/record.url?scp=85072848427&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2019-030958
DO - 10.1136/bmjopen-2019-030958
M3 - Journal article
C2 - 31575576
SN - 2044-6055
VL - 9
JO - BMJ Open
JF - BMJ Open
IS - 9
M1 - e030958
ER -