Utilization of medical technology in primary care: lessons learned from a nationwide study

Ábel Perjés, Katalin Dózsa, Tamás Tóth, Péter Pollner, Péter Torzsa

Keywords: medical devices, practice cluster, PoCT,

Background:

Expectations towards general practitioners (GPs) are increasing to provide a more comprehensive preventive- and definitive care and to integrate state-of-the-art digital solutions into daily practice. There were various government-aided programs in Hungary in the past two decades aiming at improving primary care services, some by simply subsidyzing device procurements, while others studied possible systemic changes in primary care by piloting practice cluster models.

Research questions:

Our aim was to determine the availability and utilization of various medical deivces in primary care in Hungary and to identify the right incentives that could lead to improvement in this area.

Method:

Data were collected using an online self-assessment questionnaire from 1800 Hungarian GPs registered in Hungary. Descriptive statistics, Wilcoxon’s test and χ2 test were applied to analyze the ownership and utilization of 32 types of medical devices, characteristics of the GP practices and to highlight the differences between traditional and cluster-based operating model.

Results:

Based on the responses from 27.7% of all Hungarian GPs, the medical device infrastructure was found to be limited especially in single GP-practices. Those involved in development projects of GP’s clusters in the last decade reported a wider range and significantly more intensive utilization of evidence-based technologies (average number of devices: 5.42 versus 7.56, P<.001), but even these GPs are not using some of their devices (e.g., various point of care testing devices) due to the lack of financing. In addition, GPs involved in GPs-cluster development model programmes showed significantly greater willingness for sharing relatively expensive, extra workforce-demanding technologies (χ2 = 24.5, P<.001).

Conclusions:

Financial iIncentives for better outcomes, as seen in GP cluster pilots, may provide superior results in application of modern medical technologies in primary care, as opposed to procurement-focused subsidies.

Points for discussion:

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