Ultrasonography in General Practice: insights from an implementation study in a Low-income neighborhood of Amsterdam
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Background
Ultrasonography is increasingly being used in primary care settings, facilitated by technological advancements, reduced device-related costs, and improved access to training and support. It holds particular promise for underserved communities, where barriers such as co-pays or long waiting lists can limit access to diagnostic services. This study evaluates the impact of a primary care ultrasonography service in an underserved urban community.
Methods
We conducted a retrospective cohort study of consecutive patients who underwent ultrasonography between 2019-2024 at a large primary care center (n=7877 patients) in Amsterdam the Netherlands. The primary outcomes included the frequency, indications, and diagnostic outcomes. Secondary outcomes included diagnostic accuracy, changes in clinical decision-making, referral rates, and costs.
Results
A total of 394 patients were included, of whom 62.4% underwent abdominal ultrasonography, 31.7% gynecological ultrasonography, and 5.8% other types of ultrasounds. Ultrasonography yielded conclusive results in 83.5% of cases, and reduced secondary care referrals by 58.8%. The sensitivity and specificity for ultrasonographic abnormalities were 98.9% (95%CI: 94.2-99.9%) and 89.8% (95%CI: 85.3-93.4%), respectively.
Conclusion
Primary care ultrasonography enhances diagnostic efficiency and reduces unnecessary referrals in more than half of cases. Its use in underserved communities can improve healthcare access and help address system-related health disparities. Further research is needed to assess its cost-effectiveness and scalability.
