title: Compliance with advice and appropriateness of emergency presentation following contact with the HealthDirect telephone triage service.
abstract: OBJECTIVE
  Evaluation of compliance with advice and appropriateness of emergency presentation following contact with a telephone triage service (HealthDirect).
  
  
  METHODS
  Compliance rates, triage distributions and admission rates were determined using linked HealthDirect and ED records for patients living within 2 km of an ED that presented during 2000.
  
  
  RESULTS
  Of 13 019 presentations, 842 (6.5%) were HealthDirect contacts. In the HealthDirect group there were a greater proportion of patients under the age of 15 (290, 34% vs 1598, 13.1%) and women (481, 57% vs 5610, 46%). The triage distributions and admission rates for HealthDirect contacts and other patients were similar (HealthDirect 37.6% admitted, 95% CI 34-41, others 38.4% admitted, 95% CI 38-39, Pchi2 = 0.67). Of 3996 callers to HealthDirect, 3167 (79%) complied with advice with 963 (61%) complying with advice to present and 212 (9%, 95% CI 8-10%) presenting despite advice to defer presentation. Triage distributions and admission rates for compliers and non-compliers were similar (compliers 38% admitted, 95% CI 34-41, non-compliers, 37% admitted, 95% CI 30-44, Pchi2 = 0.89).
  
  
  CONCLUSIONS
  HealthDirect contacts were of similar appropriateness to non-HealthDirect presenters and appear to attend the ED independent of HealthDirect advice. HealthDirect has a limited capacity to influence ED utilization or workload.
authors.affiliation: Acute Demand Management Unit, State Health Emergency Services, Fremantle Hospital, Australia. peter.sprivulis@health.wa.gov.au
authors.forename: Peter
authors.initials: P
authors.lastname: Sprivulis
authors.forename: Mary
authors.initials: M
authors.lastname: Carey
authors.forename: Ian
authors.initials: I
authors.lastname: Rouse
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D003376:Counseling / Q000706:statistics & numerical data; D020000:Decision Support Systems, Clinical / Q000458:organization & administration; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006302:Health Services Research; D006784:Hospitals, Teaching; D006786:Hospitals, Urban; D015277:Hotlines / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008498:Medical Record Linkage; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D010353:Patient Education as Topic / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D015397:Program Evaluation; D017678:Sex Distribution; D014218:Triage / Q000706:statistics & numerical data*; D014904:Western Australia; D016526:Workload