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

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Author

Gamst-Jensen, Hejdi ; Frischknecht Christensen, Erika ; Lippert, Freddy ; Folke, Fredrik ; Egerod, Ingrid ; Huibers, Linda ; Brabrand, Mikkel ; Tolstrup, Janne Schurmann ; Thygesen, Lau Caspar. / Self-rated worry is associated with hospital admission in out-of-hours telephone triage - a prospective cohort study. I: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2020 ; Bind 28, Nr. 1.

Bibtex

@article{df81d73dc1e04e38a4765c28b198a341,
title = "Self-rated worry is associated with hospital admission in out-of-hours telephone triage - a prospective cohort study",
abstract = "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.",
author = "Hejdi Gamst-Jensen and {Frischknecht Christensen}, Erika and Freddy Lippert and Fredrik Folke and Ingrid Egerod and Linda Huibers and Mikkel Brabrand and Tolstrup, {Janne Schurmann} and Thygesen, {Lau Caspar}",
year = "2020",
month = "6",
day = "10",
doi = "10.1186/s13049-020-00743-8",
language = "English",
volume = "28",
journal = "Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine",
issn = "1757-7241",
publisher = "BioMed Central Ltd",
number = "1",

}

RIS

TY - JOUR

T1 - Self-rated worry is associated with hospital admission in out-of-hours telephone triage - 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 - 2020/6/10

Y1 - 2020/6/10

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.

U2 - 10.1186/s13049-020-00743-8

DO - 10.1186/s13049-020-00743-8

M3 - Journal article

VL - 28

JO - Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

JF - Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

SN - 1757-7241

IS - 1

M1 - 53

ER -

ID: 60024267