TY - JOUR
T1 - Primary care physicians' access to in-house ultrasound examinations across Europe
T2 - a questionnaire study
AU - Andersen, Camilla Aakjaer
AU - Jensen, Martin Bach B.
AU - Toftegaard, Berit Skjodeberg
AU - Vedsted, Peter
AU - Harris, Michael
AU - Aubin-Auger, Isabelle
AU - Azuri, Joseph
AU - Brekke, Matte
AU - Buczkowski, Krzysztof
AU - Buono, Nicola
AU - Costiug, Emiliana
AU - Dinant, Geert-Jan
AU - Esteva, Magdalena
AU - Foreva, Gergana
AU - Babic, Svjetlana Gasparovic
AU - Hoffman, Robert
AU - Jakob, Eva
AU - Koskela, Tuomas
AU - Marzo-Castillejo, Merce
AU - Murchie, Peter
AU - Neves, Ana Luisa
AU - Petek, Davorina
AU - Ster, Marija Petek
AU - Sawicka-Powierza, Jolanta
AU - Schneider, Antonius
AU - Smyrnakis, Emmanouil
AU - Streit, Sven
AU - Thulesius, Hans
AU - Weltermann, Birgitta
AU - Örenäs Research group
N1 - Publisher Copyright:
© 2019 Author(s).
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 - organisation of health services
KW - primary care
KW - diagnostic radiology
KW - ultrasound
KW - GENERAL-PRACTITIONERS
KW - SERVICE PROFILES
KW - POINT
KW - ULTRASONOGRAPHY
U2 - 10.1136/bmjopen-2019-030958
DO - 10.1136/bmjopen-2019-030958
M3 - Article
C2 - 31575576
SN - 2044-6055
VL - 9
JO - BMJ Open
JF - BMJ Open
IS - 9
M1 - 030958
ER -