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

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.