Calling for confirmation, reassurance, and direction: Investigating patient compliance after accessing a telephone triage advice service

Abstract

Understanding the influence of a telephone triage advice service (TTAS) on patients seeking care is critical to realize enhancements in patient care, functioning of emergency departments (EDs), and effectiveness of the health system. This study addresses the question: what influence does a TTAS have on a patient's attendance at an ED and the wider health system? Records from 2016 to 2017 of 12,741 calls from a national TTAS were linked to 72,577 ED presentations to a hospital in regional Australia, retrospectively. Matching criteria included patient within the hospital's statistical local area code, age, gender, and ED attendance within 8 hours of TTAS call. Five statistical analyses of the data were conducted. There were 2857 matches. TTAS patients accessing the ED had a slightly higher proportion of women and a greater proportion of children under 4 years than usual. When TTAS confirmed callers' inclination for ED care, however only up to 69% subsequently attended the ED. When TTAS redirected others initially less inclined to more urgent care, up to 62% attended the ED. TTAS empowers vulnerable patients to access appropriate and timely services and promotes clinical and functional integration of care. Improvements of TTAS can come through investigation of callers' compliance factors. K E Y W O R D S appropriate care, care integration, emergency department health system, telephone triage advice service

Service use, clinical outcomes and user experience associated with urgent care services that use telephone-based digital triage: a systematic review

“…Presenting symptoms with highest frequency among patients, included: abdominal or digestive problems, 6.8%–12.2% of calls 5 19 22 24 39 and respiratory problems, 11.3%–11.9% 39 24 of calls. The majority of calls were made by women (range: 59%–72%).…”

Use of a paediatric advice line for parents of infants recruited to a randomised controlled trial

“…Paediatric advice services provide guidance for parents, enhance clinician-patient communication, and improve parental satisfaction and accessibility to non-urgent health advice. [2][3][4] Given approximately one in five parents used the PAL, with a high proportion of parents calling multiple times, this highlights a demand for non-urgent medical advice during early childhood. While studies have shown a growing demand for medical triage and assessment hotlines, this has not been studied in a clinical trial setting.…”

Effects of Telephone Consultation on Safety, Service Use, Patient Satisfaction, and Workload: Systematic Review and Meta-Analysis of Randomized Trials

“…Patients with certain disadvantaging characteristics (e.g., female, > 65 or < 5 years, ethnic minority, migrant identity, and poverty) are often the most frequent users of TCs and other out-of-hours services. [9][10][11][12][13] Unsafe or ineffective TC services would aggravate the vulnerability of these patients and deteriorate their health status. Although many studies found TC services to be safe and effective, 3,10,14 concerns about the quality, safety, and impact of TCs persist.…”