Self-rated worry is associated with hospital admission in out-of-hours telephone triage - a prospective cohort study

Autor: Lau Caspar Thygesen, Ingrid Egerod, Janne Schurmann Tolstrup, Hejdi Gamst-Jensen, Mikkel Brabrand, Freddy Lippert, Linda Huibers, Fredrik Folke, Erika Frischknecht Christensen
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
Self-Assessment
Patient-centered care
Denmark
Anxiety/diagnosis
Anxiety
Decision support systems
Critical Care and Intensive Care Medicine
Logistic regression
0302 clinical medicine
Acute care
030212 general & internal medicine
Prospective Studies
Prospective cohort study
Child
media_common
Original Research
030503 health policy & services
lcsh:Medical emergencies. Critical care. Intensive care. First aid
Middle Aged
Hospitalization
Child
Preschool
Emergency medicine
Female
Worry
0305 other medical science
Adult
medicine.medical_specialty
Adolescent
media_common.quotation_subject
Clinical Decision-Making
03 medical and health sciences
Young Adult
After-Hours Care
Hotlines
medicine
Humans
Patient participation
Aged
Primary Health Care
business.industry
Telephone hotlines
Infant
Newborn
Infant
lcsh:RC86-88.9
Odds ratio
Triage
Confidence interval
Telephone
Help-seeking behavior
business
Decision making
Zdroj: Gamst-Jensen, H, Frischknecht Christensen, E, Lippert, F, Folke, F, Egerod, I, Huibers, L, Brabrand, M, Tolstrup, J S & Thygesen, L C 2020, ' Self-rated worry is associated with hospital admission in out-of-hours telephone triage-a prospective cohort study ', Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, vol. 28, 53 . https://doi.org/10.1186/s13049-020-00743-8
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, Vol 28, Iss 1, Pp 1-9 (2020)
Gamst-Jensen, H, Frischknecht Christensen, E, Lippert, F, Folke, F, Egerod, I, Huibers, L, Brabrand, M, Tolstrup, J S & Thygesen, L C 2020, ' Self-rated worry is associated with hospital admission in out-of-hours telephone triage-a prospective cohort study ', Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, vol. 28, no. 1, 53 . https://doi.org/10.1186/s13049-020-00743-8
Gamst-Jensen, H, Frischknecht Christensen, E, Lippert, F, Folke, F, Egerod, I, Huibers, L, Brabrand, M, Tolstrup, J S & Thygesen, L C 2020, ' Self-rated worry is associated with hospital admission in out-of-hours telephone triage : a prospective cohort study ', Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, vol. 28, 53 . https://doi.org/10.1186/s13049-020-00743-8
Popis: 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.
Databáze: OpenAIRE
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