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Associations between degree-of-worry, self-rated health and acute hospitalisation after contacting a medical helpline: a Danish prospective cohort study

OBJECTIVES: Self-rated health (SRH) is a strong predictor for healthcare utilisation among chronically ill patients. However, its association with acute hospitalisation is unclear. Individuals’ perception of urgency in acute illness expressed as degree-of-worry (DOW) is however associated with acute...

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Autores principales: Jensen, Andrea Nedergaard, Kristiansen, Maria, Tolstrup, Janne Schurmann, Gamst-Jensen, Hejdi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8162089/
https://www.ncbi.nlm.nih.gov/pubmed/34045212
http://dx.doi.org/10.1136/bmjopen-2020-042287
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author Jensen, Andrea Nedergaard
Kristiansen, Maria
Tolstrup, Janne Schurmann
Gamst-Jensen, Hejdi
author_facet Jensen, Andrea Nedergaard
Kristiansen, Maria
Tolstrup, Janne Schurmann
Gamst-Jensen, Hejdi
author_sort Jensen, Andrea Nedergaard
collection PubMed
description OBJECTIVES: Self-rated health (SRH) is a strong predictor for healthcare utilisation among chronically ill patients. However, its association with acute hospitalisation is unclear. Individuals’ perception of urgency in acute illness expressed as degree-of-worry (DOW) is however associated with acute hospitalisation. This study examines DOW and SRH, respectively, and their association with acute hospitalisation within 48 hours after calling a medical helpline. DESIGN: A prospective cohort study. SETTING: The Medical Helpline 1813 (MH1813) in the Capital Region of Denmark, Copenhagen. PARTICIPANTS: Adult (≥18 years of age) patients and relatives/close friends calling the MH1813 between 24 January and 9 February 2017. A total of 6812 callers were included. OUTCOME MEASURES: The primary outcome measure was acute hospitalisation. Callers rated their DOW (1=minimum worry, 5=maximum worry) and SRH (1=excellent, 5=poor). Covariates included age, sex, Charlson Comorbidity Score and reason for calling. Logistic regression was conducted to measure the associations in three models: (1) crude; (2) age-and-sex-adjusted; (3) full fitted model (age, sex, comorbidity, reason for calling, DOW/SRH). RESULTS: Of 6812 callers, 492 (7.2%) were acutely hospitalised. Most callers rated their health as being excellent to good (65.3%) and 61% rated their worry to be low (DOW 1–3). Both the association between DOW and acute hospitalisation and SRH and acute hospitalisation indicated a dose–response relationship: DOW 1=ref, 3=1.8 (1.1;3.1), 5=3.5 (2.0;5.9) and SRH 1=ref, 3=0.8 (0.6;1.4), 5=1.6 (1.1;2.4). The association between DOW and acute hospitalisation decreased slightly, when further adjusting for SRH, whereas the estimates for SRH weakened markedly when including DOW. CONCLUSIONS: DOW and poor SRH were associated with acute hospitalisation. However, DOW had a stronger association with hospitalisation than SRH. This suggests that DOW may capture acutely ill patients’ perception of urgency better than SRH in relation to acute hospitalisation after calling a medical helpline. TRIAL REGISTRATION NUMBER: NCT02979457.
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spelling pubmed-81620892021-06-10 Associations between degree-of-worry, self-rated health and acute hospitalisation after contacting a medical helpline: a Danish prospective cohort study Jensen, Andrea Nedergaard Kristiansen, Maria Tolstrup, Janne Schurmann Gamst-Jensen, Hejdi BMJ Open Emergency Medicine OBJECTIVES: Self-rated health (SRH) is a strong predictor for healthcare utilisation among chronically ill patients. However, its association with acute hospitalisation is unclear. Individuals’ perception of urgency in acute illness expressed as degree-of-worry (DOW) is however associated with acute hospitalisation. This study examines DOW and SRH, respectively, and their association with acute hospitalisation within 48 hours after calling a medical helpline. DESIGN: A prospective cohort study. SETTING: The Medical Helpline 1813 (MH1813) in the Capital Region of Denmark, Copenhagen. PARTICIPANTS: Adult (≥18 years of age) patients and relatives/close friends calling the MH1813 between 24 January and 9 February 2017. A total of 6812 callers were included. OUTCOME MEASURES: The primary outcome measure was acute hospitalisation. Callers rated their DOW (1=minimum worry, 5=maximum worry) and SRH (1=excellent, 5=poor). Covariates included age, sex, Charlson Comorbidity Score and reason for calling. Logistic regression was conducted to measure the associations in three models: (1) crude; (2) age-and-sex-adjusted; (3) full fitted model (age, sex, comorbidity, reason for calling, DOW/SRH). RESULTS: Of 6812 callers, 492 (7.2%) were acutely hospitalised. Most callers rated their health as being excellent to good (65.3%) and 61% rated their worry to be low (DOW 1–3). Both the association between DOW and acute hospitalisation and SRH and acute hospitalisation indicated a dose–response relationship: DOW 1=ref, 3=1.8 (1.1;3.1), 5=3.5 (2.0;5.9) and SRH 1=ref, 3=0.8 (0.6;1.4), 5=1.6 (1.1;2.4). The association between DOW and acute hospitalisation decreased slightly, when further adjusting for SRH, whereas the estimates for SRH weakened markedly when including DOW. CONCLUSIONS: DOW and poor SRH were associated with acute hospitalisation. However, DOW had a stronger association with hospitalisation than SRH. This suggests that DOW may capture acutely ill patients’ perception of urgency better than SRH in relation to acute hospitalisation after calling a medical helpline. TRIAL REGISTRATION NUMBER: NCT02979457. BMJ Publishing Group 2021-05-26 /pmc/articles/PMC8162089/ /pubmed/34045212 http://dx.doi.org/10.1136/bmjopen-2020-042287 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Emergency Medicine
Jensen, Andrea Nedergaard
Kristiansen, Maria
Tolstrup, Janne Schurmann
Gamst-Jensen, Hejdi
Associations between degree-of-worry, self-rated health and acute hospitalisation after contacting a medical helpline: a Danish prospective cohort study
title Associations between degree-of-worry, self-rated health and acute hospitalisation after contacting a medical helpline: a Danish prospective cohort study
title_full Associations between degree-of-worry, self-rated health and acute hospitalisation after contacting a medical helpline: a Danish prospective cohort study
title_fullStr Associations between degree-of-worry, self-rated health and acute hospitalisation after contacting a medical helpline: a Danish prospective cohort study
title_full_unstemmed Associations between degree-of-worry, self-rated health and acute hospitalisation after contacting a medical helpline: a Danish prospective cohort study
title_short Associations between degree-of-worry, self-rated health and acute hospitalisation after contacting a medical helpline: a Danish prospective cohort study
title_sort associations between degree-of-worry, self-rated health and acute hospitalisation after contacting a medical helpline: a danish prospective cohort study
topic Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8162089/
https://www.ncbi.nlm.nih.gov/pubmed/34045212
http://dx.doi.org/10.1136/bmjopen-2020-042287
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