Point-of-care ultrasonography in Norwegian out-of-hours primary health care

Abstract

Objective: The objective of this study is to determine the extent of ultrasound availability in Norwegian casualty clinics and estimate the prevalence of its use.

Design: A retrospective study based on a national casualty clinic registry and data from reimbursement claims.

Setting: Out-of-hours primary health care in Norway.

Subjects: All Norwegian casualty clinics in 2016 and reimbursement claims from 2008 to 2015.

Main outcome measures: Percent of casualty clinics with ultrasound, types of ultrasound devices and probes, reasons for/against ultrasound access, characteristics of clinics with/without ultrasound, frequency of five ultrasound indications and characteristics of the physicians using/not using ultrasound.

Results: Out of 182 casualty clinics, 41 (23%) reported access to ultrasound. Mobile (49%) and stationary (44%) devices were most frequent. Physician request was the most common cited reason for ultrasound access (66%). Neither population served by the casualty clinic nor distance to hospital showed any clear association with ultrasound access. All of the five ultrasound reimbursement codes showed a substantial increase from 2008 to 2015 with 14.1 ultrasound examinations being performed per 10,000 consultations in 2015. Only 6.5% of physicians performed ultrasound in 2015 and males were significantly more likely to use ultrasound than females (OR 1.85, 95% CI: 1.38–2.47, p < .001), even when adjusted for age, speciality status and geography.

Conclusions: Although the use of ultrasound is increasing in out-of-hours Norwegian primary health care, most casualty clinics do not have access and only a minority of physicians use ultrasound.

Keywords:

• Point-of-care ultrasonography
• ultrasound
• out-of-hours
• emergency health care
• Norway
• casualty clinic

Disclosure statement

This study was exempted from ethical approval and the authors report no conflicts of interest. The authors report no conflicts of interest.

Notes on contributors

Kjetil Myhr, M.D. and researcher at the National Centre for Emergency Primary Health Care, Uni Research Health, Bergen, Norway.

Hogne Sandvik, M.D., Ph.D and researcher at the National Centre for Emergency Primary Health Care, Uni Research Health, Bergen, Norway.

Tone Morken, Physiotherapist, dr. philos and researcher at the National Centre for Emergency Primary Health Care, Uni Research Health, Bergen, Norway.

Steinar Hunskaar, M.D., Ph.D, director at the National Centre for Emergency Primary Health Care, Uni Research Health, Bergen, Norway and professor at the Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.

Additional information

Funding

The study was funded by the National Centre for Emergency Primary Health Care, Uni Research Health, Uni Research AS, Bergen, Norway.