Irish general practitioner (GP) perspectives on impact of direct access radiology on patient care in the community: results from a mixed-methods study

Ir J Med Sci. 2024 Feb;193(1):425-434. doi: 10.1007/s11845-023-03419-1. Epub 2023 Jun 24.

Abstract

Background: Since winter 2020/21, general practitioners (GPs) in the Republic of Ireland (RoI) have been granted access to diagnostic imaging studies on a new publicly funded pathway, expediting access to services previously obtained via hospital-based doctors.

Aims: Outline GP perspectives on imaging studies obtained via the new "GP Access to Community Diagnostics" initiative.

Methods: A mixed-methods design was employed. Referrals over the first six months of 2019 and 2021 were collated by a private imaging provider, and a randomly selected subset of 2021 studies (maximum 30 referrals per GP) was returned to participating GPs to provide detail on the impact on each patient's care. In-depth qualitative interviews were also conducted with participating GPs.

Results: Eleven GPs supplied detailed information on 81 studies organized through the new initiative. GPs reported that the initiative had led to a large proportion of cases being managed solely in general practice, with an 81% reduction in referrals to acute hospital settings and a 58% reduction in referrals to secondary care clinics. GPs felt imaging studies improved patient care in 86% of cases and increased GP workload in 58% of cases. GP qualitative interviews revealed four key themes: improved patient care, increased GP workload, reduction in hospital referrals, and opinions on ongoing management of such initiatives, including guidelines.

Conclusions: GPs felt enhancing access to diagnostics improved patient care by expediting diagnosis, decision-making, and treatment and by reducing hospital referrals. GPs were generally positive about the initiative and made some suggestions on future management of the initiative.

Keywords: Diagnostic imaging; General practice; Hospital avoidance; Primary care; Radiology; Referral.

MeSH terms

  • General Practice*
  • General Practitioners*
  • Humans
  • Patient Care
  • Radiology*
  • Referral and Consultation