Journal Article

Follow-through after calling a nurse telephone advice line: a population-based study

Carolyn De Coster, Hude Quan, Rod Elford, Bing Li, Lara Mazzei and Scott Zimmer

in Family Practice

Volume 27, issue 3, pages 271-278
Published in print June 2010 | ISSN: 0263-2136
Published online March 2010 | e-ISSN: 1460-2229 | DOI: http://dx.doi.org/10.1093/fampra/cmq003
Follow-through after calling a nurse telephone advice line: a population-based study

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Background. Nurse telephone advice (NTA) lines, a major initiative in primary health care reform, provide symptom triage and health information. Compliance studies utilizing database analysis are frequently limited to a defined population, such as children or Emergency Department (ED) users.

Objectives. To explore caller characteristics associated with following NTA advice to go to the ED, see a health care professional or self-care for Calgary, Canada (population 1 million).

Methods. NTA data were linked with utilization data to assess ED and physician visits following a call. Four nurse advice categories were defined: go to ED, health care provider in 24 hours, health care provider in 72 hours if symptoms persist and self-care. Follow-through was defined based on health care utilization within specified time periods following the call. Logistic regression identified characteristics associated with follow-through of NTA nurse advice; characteristics included age, sex, neighbourhood income, health status, time of call and type of care protocol.

Results. Follow-through was highest for self-care advice (83.7%), followed by ED advice (52.3%) and then 24-hour advice (43.2%). Lower follow-through on ED or 24-hour advice was associated with age <4 years, and having lower income, and the opposite was true for self-care advice. Patients with a cardiac complaint had the highest odds of following ED advice. Patients with a gastrointestinal or obstetrics/gynaecology/genitourinary complaint were less likely to follow 24-hour advice. Patients with fever were less likely to follow self-care advice.

Conclusions. Understanding characteristics associated with lower follow-through may help the NTA service to refine its approaches to clients.

Keywords: Emergency medicine; family medicine; telemedicine

Journal Article.  4067 words.  Illustrated.

Subjects: Primary Care

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