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Self-rated worry is associated with hospital admission in out-of-hours telephone triage – a prospective cohort study
OBJECTIVE: Telephone triage manages patient flow in acute care, but a lack of visual cues and vague descriptions of symptoms challenges clinical decision making. We aim to investigate the association between the caller’s subjective perception of illness severity expressed as “degree-of-worry” (DOW)...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288501/ https://www.ncbi.nlm.nih.gov/pubmed/32522240 http://dx.doi.org/10.1186/s13049-020-00743-8 |
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author | Gamst-Jensen, Hejdi Frischknecht Christensen, Erika Lippert, Freddy Folke, Fredrik Egerod, Ingrid Huibers, Linda Brabrand, Mikkel Tolstrup, Janne Schurmann Thygesen, Lau Caspar |
author_facet | Gamst-Jensen, Hejdi Frischknecht Christensen, Erika Lippert, Freddy Folke, Fredrik Egerod, Ingrid Huibers, Linda Brabrand, Mikkel Tolstrup, Janne Schurmann Thygesen, Lau Caspar |
author_sort | Gamst-Jensen, Hejdi |
collection | PubMed |
description | OBJECTIVE: Telephone triage manages patient flow in acute care, but a lack of visual cues and vague descriptions of symptoms challenges clinical decision making. We aim to investigate the association between the caller’s subjective perception of illness severity expressed as “degree-of-worry” (DOW) and hospital admissions within 48 h. DESIGN AND SETTING: A prospective cohort study was performed from January 24th to February 9th, 2017 at the Medical Helpline 1813 (MH1813) in Copenhagen, Denmark. The MH1813 is a primary care out-of-hours service. PARTICIPANTS: Of 38,787 calls received at the MH1813, 11,338 met the inclusion criteria (caller being patient or close friend/relative and agreement to participate). Participants rated their DOW on a 5-point scale (1 = minimum worry, 5 = maximum worry) before talking to a call handler. MAIN OUTCOME MEASURE: Information on hospitalization within 48 h after the call, was obtained from the Danish National Patient Register. The association was assessed using logistic regression in three models: 1) crude, 2) age-and-gender adjusted and 3) age, gender, co-morbidity, reason for calling and caller status adjusted. RESULTS: A total of 581 participants (5.1%) were admitted to the hospital, of whom 170 (11.3%) presented with a maximum DOW, with a crude odds ratio (OR) for hospitalization of 6.1 (95% confidence interval (CI) 3.9 to 9.6) compared to minimum DOW. Estimates showed dose-response relationship between DOW and hospitalization. In the fully adjusted model, the ORs decreased to 3.1 (95%CI 2.0 to 5.0) for DOW = 5, 3.2 (2.0 to 5.0) for DOW = 4, 1.6 (1.0 to 2.6) for DOW = 3 and 0.8 (0.5 to 1.4) for DOW = 2 compared to minimum DOW. CONCLUSION: Patients’ self-assessment of illness severity as DOW was associated with subsequent hospital admission. Further, it may be beneficial in supporting clinical decision making in telephone triage. Finally, it might be useful as a measure to facilitate patient participation in the triage process. |
format | Online Article Text |
id | pubmed-7288501 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-72885012020-06-11 Self-rated worry is associated with hospital admission in out-of-hours telephone triage – a prospective cohort study Gamst-Jensen, Hejdi Frischknecht Christensen, Erika Lippert, Freddy Folke, Fredrik Egerod, Ingrid Huibers, Linda Brabrand, Mikkel Tolstrup, Janne Schurmann Thygesen, Lau Caspar Scand J Trauma Resusc Emerg Med Original Research OBJECTIVE: Telephone triage manages patient flow in acute care, but a lack of visual cues and vague descriptions of symptoms challenges clinical decision making. We aim to investigate the association between the caller’s subjective perception of illness severity expressed as “degree-of-worry” (DOW) and hospital admissions within 48 h. DESIGN AND SETTING: A prospective cohort study was performed from January 24th to February 9th, 2017 at the Medical Helpline 1813 (MH1813) in Copenhagen, Denmark. The MH1813 is a primary care out-of-hours service. PARTICIPANTS: Of 38,787 calls received at the MH1813, 11,338 met the inclusion criteria (caller being patient or close friend/relative and agreement to participate). Participants rated their DOW on a 5-point scale (1 = minimum worry, 5 = maximum worry) before talking to a call handler. MAIN OUTCOME MEASURE: Information on hospitalization within 48 h after the call, was obtained from the Danish National Patient Register. The association was assessed using logistic regression in three models: 1) crude, 2) age-and-gender adjusted and 3) age, gender, co-morbidity, reason for calling and caller status adjusted. RESULTS: A total of 581 participants (5.1%) were admitted to the hospital, of whom 170 (11.3%) presented with a maximum DOW, with a crude odds ratio (OR) for hospitalization of 6.1 (95% confidence interval (CI) 3.9 to 9.6) compared to minimum DOW. Estimates showed dose-response relationship between DOW and hospitalization. In the fully adjusted model, the ORs decreased to 3.1 (95%CI 2.0 to 5.0) for DOW = 5, 3.2 (2.0 to 5.0) for DOW = 4, 1.6 (1.0 to 2.6) for DOW = 3 and 0.8 (0.5 to 1.4) for DOW = 2 compared to minimum DOW. CONCLUSION: Patients’ self-assessment of illness severity as DOW was associated with subsequent hospital admission. Further, it may be beneficial in supporting clinical decision making in telephone triage. Finally, it might be useful as a measure to facilitate patient participation in the triage process. BioMed Central 2020-06-10 /pmc/articles/PMC7288501/ /pubmed/32522240 http://dx.doi.org/10.1186/s13049-020-00743-8 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Original Research Gamst-Jensen, Hejdi Frischknecht Christensen, Erika Lippert, Freddy Folke, Fredrik Egerod, Ingrid Huibers, Linda Brabrand, Mikkel Tolstrup, Janne Schurmann Thygesen, Lau Caspar Self-rated worry is associated with hospital admission in out-of-hours telephone triage – a prospective cohort study |
title | Self-rated worry is associated with hospital admission in out-of-hours telephone triage – a prospective cohort study |
title_full | Self-rated worry is associated with hospital admission in out-of-hours telephone triage – a prospective cohort study |
title_fullStr | Self-rated worry is associated with hospital admission in out-of-hours telephone triage – a prospective cohort study |
title_full_unstemmed | Self-rated worry is associated with hospital admission in out-of-hours telephone triage – a prospective cohort study |
title_short | Self-rated worry is associated with hospital admission in out-of-hours telephone triage – a prospective cohort study |
title_sort | self-rated worry is associated with hospital admission in out-of-hours telephone triage – a prospective cohort study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288501/ https://www.ncbi.nlm.nih.gov/pubmed/32522240 http://dx.doi.org/10.1186/s13049-020-00743-8 |
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