Significant variation in non-acute ECG use in Finnish health centres

BACKGROUND ECG is one of the most expensive tests in Finnish primary health care because of high volume and high operating costs. There are no specific Finnish guidelines on ECG use in non-acute primary health care practices.

METHODS Our Primary Care Research Network Tutka collected the data from 20 health centres in Finland by questionnaire during November 2016. We investigated the variation in non-acute ECG referrals between practices and whether there were local guidelines regarding ECG examinations.

RESULTS The percentage of non-acute ECGs varied from 6% to 60% between different health centres based on the number of general practitioner (GP) consultations during one month. Based on all consultations the percentage was lower (3%–20%). The number of ECGs performed was higher when there were more GP consultations of elderly patients, when nurses were able to make an ECG referral, and when the ratio of nurse consultations to GP consultations was greater.

CONCLUSIONS There is significant, up to tenfold, variation in ECG use in non-acute consultations between different health centres. In addition to the age distribution of the patients, differences between the roles of nurses and GPs when referring patients for ECG examinations can have an impact on the variation.