title: Satisfaction and public health cost of a statewide influenza nurse triage line in response to pandemic H1N1 influenza.
abstract: BACKGROUND
  The 2009 H1N1 pandemic strained healthcare systems. There was a need for supportive services, rapid antiviral access, and minimization of unnecessary healthcare contacts particularly face-to-face interactions. In response, the Minnesota Department of Health (MDH) launched a telephone-based nurse triage line (NTL) called the Minnesota FluLine coordinating all major MN healthcare systems with NTLs to form a single toll-free number triage service. Callers were evaluated for symptoms of influenza-like illness (ILI) and were prescribed an antiviral if indicated, using nurse administered protocols.
  
  
  METHODS
  To determine caller outcomes, associated healthcare seeking, and satisfaction a telephone survey of Minnesota FluLine callers was conducted using a 5% random sample of those who completed the protocol and those who did not.
  
  
  RESULTS
  Of 6,122 callers with ILI who began the nurse protocol administered by the contract NTL, 1,221 people were contacted for the survey and 325 agreed to participate; response rate was 26%. Of those who completed the nurse protocol 73% said they would have sought healthcare without the Minnesota FluLine, 89% reported the service was moderately or very helpful, and 91% reported being satisfied or very satisfied. Of those not completing the protocol, 50% reported the service was moderately or very helpful and 50% reported being satisfied or very satisfied. 72% of qualitative responses to open-ended questions were positive regarding the MN FluLine. Cost to MDH for operating the Minnesota FluLine service was $331,226 to service 27,391 callers ($12.09/call).
  
  
  CONCLUSIONS
  The Minnesota FluLine diverted patients with mild ILI symptoms away from acute care visits at low cost and had a high rate of satisfaction among callers. Early intervention likely prevented morbidity and possibly additional cases. NTLs are powerful and flexible tools for pandemic response and should be considered as an important tool for future emergency responses.
authors: School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
authors: Alicen B
authors: AB
authors: Spaulding
authors: Deborah
authors: D
authors: Radi
authors: Heather
authors: H
authors: Macleod
authors: Ruth
authors: R
authors: Lynfield
authors: Michelle
authors: M
authors: Larson
authors: Terri
authors: T
authors: Hyduke
authors: Peter
authors: P
authors: Dehnel
authors: Aaron S
authors: AS
authors: DeVries
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D039604:Answering Services; D002648:Child; D002675:Child, Preschool; D005069:Evaluation Studies as Topic; D005260:Female; D017048:Health Care Costs; D006306:Health Surveys; D015277:Hotlines; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000191:economics* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D009726:Nurses; D058873:Pandemics; D017060:Patient Satisfaction; D011634:Public Health / Q000191:economics*; D011795:Surveys and Questionnaires; D014218:Triage / Q000191:economics*; D055815:Young Adult