Follow-through after calling a nurse telephone advice line: a population-based study.
BACKGROUND
Nurse telephone advice (NTA) lines, a major initiative in primary health care reform, provide symptom triage and health information. Compliance studies utilizing database analysis are frequently limited to a defined population, such as children or Emergency Department (ED) users.


OBJECTIVE
To explore caller characteristics associated with following NTA advice to go to the ED, see a health care professional or self-care for Calgary, Canada (population 1 million).


METHODS
NTA data were linked with utilization data to assess ED and physician visits following a call. Four nurse advice categories were defined: go to ED, health care provider in 24 hours, health care provider in 72 hours if symptoms persist and self-care. Follow-through was defined based on health care utilization within specified time periods following the call. Logistic regression identified characteristics associated with follow-through of NTA nurse advice; characteristics included age, sex, neighbourhood income, health status, time of call and type of care protocol.


RESULTS
Follow-through was highest for self-care advice (83.7%), followed by ED advice (52.3%) and then 24-hour advice (43.2%). Lower follow-through on ED or 24-hour advice was associated with age <4 years, and having lower income, and the opposite was true for self-care advice. Patients with a cardiac complaint had the highest odds of following ED advice. Patients with a gastrointestinal or obstetrics/gynaecology/genitourinary complaint were less likely to follow 24-hour advice. Patients with fever were less likely to follow self-care advice.


CONCLUSIONS
Understanding characteristics associated with lower follow-through may help the NTA service to refine its approaches to clients.
De Coster
Carolyn
C
Data Integration, Measurement and Reporting, Alberta Health Services, Calgary, Alberta. carolyn.decoster@albertahealthservices.ca
Quan
Hude
H
Elford
Rod
R
Li
Bing
B
Mazzei
Lara
L
Zimmer
Scott
S
D000293:Adolescent; D000328:Adult; D000416:Alberta; D002648:Child; D002675:Child, Preschool; D003266:Continuity of Patient Care; D016208:Databases, Factual; D004635:Emergency Medicine; D005194:Family Practice; D005260:Female; D015277:Hotlines; D006801:Humans; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D019114:Remote Consultation; D055815:Young Adult