Does telephone triage delay significant medical treatment?: Advice nurse service vs on-call pediatricians.
BACKGROUND
Advice nurse call centers are used to ensure access to medical advice, thereby potentially reducing the costs of health services.


OBJECTIVE
To determine if medical advice from advice nurses and on-call physicians delays significant medical treatment in a general pediatrics population.


METHODS
Randomized controlled trial.


METHODS
A university general pediatrics faculty practice.


METHODS
Parents or guardians calling for after-hours advice regarding their children.Intervention After-hours medical advice calls were randomized at the time of the call to an advice nurse or an on-call pediatrician.


METHODS
The proportion of callers who sought medical care not advised by the advice nurse or on-call pediatrician and the proportion who received unadvised significant care.


RESULTS
There were 1182 advice calls: 566 in the pediatrician group and 616 in the advice nurse group. There were no significant differences in the types of telephone triage advice in the physician and advice nurse groups. There was no significant difference in the proportion of callers who sought unadvised care (108 [19.9%] in the physician group vs 110 [19.0%] in the advice nurse group) or in the proportion of callers who received unadvised significant care (23 [4.2%] in the physician group vs 25 [4.3%] in the advice nurse group).


CONCLUSIONS
The proportions of callers who sought unadvised medical care and who received unadvised significant care were not significantly different in the advice nurse and pediatrician groups. This suggests that advice nurses do not delay significant medical treatment when compared with pediatricians.
Lee
Thomas J
TJ
Emergency Medicine Center, David Geffen School of Medicine, University of California, Los Angeles, USA.
Baraff
Larry J
LJ
Guzy
Judith
J
Johnson
David
D
Woo
Heide
H
D000046:Academic Medical Centers; D039602:After-Hours Care / Q000379:methods / Q000706:statistics & numerical data*; D002675:Child, Preschool; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010371:Pediatric Nursing / Q000379:methods* / Q000706:statistics & numerical data; D010372:Pediatrics / Q000379:methods* / Q000706:statistics & numerical data; D012494:Sampling Studies; D011795:Surveys and Questionnaires; D013689:Telephone; D013997:Time Factors; D014218:Triage / Q000379:methods / Q000706:statistics & numerical data*; D014481:United States