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 |
Externí odkaz: |