Self-rated worry is associated with hospital admission in out-of-hours telephone triage: a prospective cohort study
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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.
I: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, Bind 28, 53, 2020.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Self-rated worry is associated with hospital admission in out-of-hours telephone triage
T2 - a prospective cohort study
AU - Gamst-Jensen, Hejdi
AU - Frischknecht Christensen, Erika
AU - Lippert, Freddy
AU - Folke, Fredrik
AU - Egerod, Ingrid
AU - Huibers, Linda
AU - Brabrand, Mikkel
AU - Tolstrup, Janne Schurmann
AU - Thygesen, Lau Caspar
PY - 2020
Y1 - 2020
N2 - 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.
AB - 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.
KW - Adolescent
KW - Adult
KW - After-Hours Care
KW - Aged
KW - Anxiety/diagnosis
KW - Child
KW - Child, Preschool
KW - Clinical Decision-Making
KW - Denmark
KW - Female
KW - Hospitalization
KW - Hotlines
KW - Humans
KW - Infant
KW - Infant, Newborn
KW - Male
KW - Middle Aged
KW - Primary Health Care
KW - Prospective Studies
KW - Self-Assessment
KW - Telephone
KW - Triage
KW - Young Adult
U2 - 10.1186/s13049-020-00743-8
DO - 10.1186/s13049-020-00743-8
M3 - Journal article
C2 - 32522240
VL - 28
JO - Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
JF - Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
SN - 1757-7241
M1 - 53
ER -
ID: 257036920