Characteristics and triage in older citizens calling a semi-acute medical helpline in Denmark: a prospective cohort study

OBJECTIVES: To investigate baseline characteristics associated with older citizens calling the medical helpline 1813 (MH1813) in Denmark and how these baseline characteristics were associated with triage outcomes in a subset population of patients with high degree of worry (DOW).

SETTING: In the Capital Region of Denmark people with acute, non-life-threatening illnesses or injuries are triaged through a single-tier MH1813 for acute healthcare services.

PARTICIPANTS: Participants were gathered from a prospective cohort established between 24 January and 9 February 2017 who called the MH1813. Out of 11,413 citizens, 1525 (13.3%) were elderly (≥ 65 years). Callers' identification, age, sex, and contact with general practitioner (GP) prior to MH1813-call were collected from the medical helpline's records. Data were enriched using the callers' self-rated health, self-evaluated DOW, and registry data on comorbidities.

RESULTS: Forty-two percent of call issues were terminated without any further action. Among 882 triaged to a hospital face-to-face consultation, n = 315 (36%) were admitted and 2/3 discharged directly from the emergency department. Approx. one third of the most worried older callers have had a contact with their GP prior to the MH1813 call. A high level on Charlson Comorbidity Index and high DOW significantly increased risk of admission. Adjusted self-rated health was not significantly associated with admission within the subset group of older self-callers and high DOW. Men more often than women, were referred to face-to-face consultation (46% vs. 37%) and subsequent admission (23% vs. 18%), though potentially explained by a higher comorbidity level in men.

CONCLUSION: The MH1813 triage revealed that older callers were triaged to Face-to-face consultations if they had high DOW or were men representing a higher level of comorbidities than women. The patients' perspectives on being alone, loneliness, rejection of Face-to-face triage, and the re-transition dilemma, needs to be further investigated.