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

Camilla Aakjær Andersen, Martin Bach B. Jensen, Berit Skjødeberg Toftegaard, Peter Vedsted, Michael Harris, Örenäs Research Group

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Article numbere030958
Pages (from-to)1-8
Number of pages8
JournalBMJ Open
Volume9
Issue number9
Early online date30 Sep 2019
DOIs
Publication statusPublished - 30 Sep 2019

Keywords

  • diagnostic radiology
  • organisation of health services
  • primary care
  • ultrasound

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Aakjær Andersen, C., Jensen, M. B. B., Toftegaard, B. S., Vedsted, P., Harris, M., & Research Group, Ö. (2019). Primary care physicians' access to in-house ultrasound examinations across Europe: A questionnaire study. BMJ Open, 9(9), 1-8. [e030958]. https://doi.org/10.1136/bmjopen-2019-030958

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; Research Group, Örenäs.

In: BMJ Open, Vol. 9, No. 9, e030958, 30.09.2019, p. 1-8.

Research output: Contribution to journalArticle

Aakjær Andersen, C, Jensen, MBB, Toftegaard, BS, Vedsted, P, Harris, M & Research Group, Ö 2019, 'Primary care physicians' access to in-house ultrasound examinations across Europe: A questionnaire study', BMJ Open, vol. 9, no. 9, e030958, pp. 1-8. https://doi.org/10.1136/bmjopen-2019-030958
Aakjær Andersen C, Jensen MBB, Toftegaard BS, Vedsted P, Harris M, Research Group Ö. Primary care physicians' access to in-house ultrasound examinations across Europe: A questionnaire study. BMJ Open. 2019 Sep 30;9(9):1-8. e030958. https://doi.org/10.1136/bmjopen-2019-030958
Aakjær Andersen, Camilla ; Jensen, Martin Bach B. ; Toftegaard, Berit Skjødeberg ; Vedsted, Peter ; Harris, Michael ; Research Group, Örenäs. / Primary care physicians' access to in-house ultrasound examinations across Europe : A questionnaire study. In: BMJ Open. 2019 ; Vol. 9, No. 9. pp. 1-8.
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abstract = "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.",
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AU - Vedsted, Peter

AU - Harris, Michael

AU - Research Group, Örenäs

N1 - © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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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.

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