title: Telephone triage by GPs in out-of-hours primary care in Denmark: a prospective observational study of efficiency and relevance.
abstract: BACKGROUND
  In the UK, telephone triage in out-of-hours primary care is mostly managed by nurses, whereas GPs perform triage in Denmark.
  
  
  OBJECTIVE
  To describe telephone contacts triaged to face-to-face contacts, GP-assessed relevance, and factors associated with triage to face-to-face contact.
  
  
  METHODS
  A prospective observational study in Danish out-of-hours primary care, conducted from June 2010 to May 2011.
  
  
  METHODS
  Information on patients was collected from the electronic patient administration system and GPs completed electronic questionnaires about the contacts. The GPs conducting the face-to-face contacts assessed relevance of the triage to face-to-face contacts. The authors performed binomial regression analyses, calculating relative risk (RR) and 95% confidence intervals.
  
  
  RESULTS
  In total, 59.2% of calls ended with a telephone consultation. Factors associated with triage to a face-to-face contact were: patient age >40 years (40-64: RR = 1.13; >64: RR = 1.34), persisting problem for 12-24 hours (RR = 1.15), severe problem (RR = 2.60), potentially severe problem (RR = 5.81), and non-severe problem (RR = 2.23). Face-to-face contacts were assessed as irrelevant for 12.7% of clinic consultations and 11.7% of home visits. A statistically significantly higher risk of irrelevant face-to-face contact was found for a persisting problem of >24 hours (RR = 1.25), contact on weekday nights (RR = 1.25), and contact <2 hours before the patient's own GP's opening time (RR = 1.80).
  
  
  CONCLUSIONS
  Around 12% of all face-to-face consultations in the study are assessed as irrelevant by GP colleagues, suggesting that GP triage is efficient. Knowledge of the factors influencing triage can provide better education for GPs, but future studies are needed to investigate other quality aspects of GP telephone triage.
authors.forename: Linda
authors.initials: L
authors.lastname: Huibers
authors.forename: Grete
authors.initials: G
authors.lastname: Moth
authors.forename: Anders H
authors.initials: AH
authors.lastname: Carlsen
authors.forename: Morten B
authors.initials: MB
authors.lastname: Christensen
authors.forename: Peter
authors.initials: P
authors.lastname: Vedsted
mesh_terms: D000293:Adolescent; D000328:Adult; D039602:After-Hours Care / Q000592:standards / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D001071:Appointments and Schedules; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D020000:Decision Support Systems, Clinical; D003718:Denmark; D017598:Efficiency, Organizational / Q000592:standards*; D005260:Female; D058005:General Practitioners; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011320:Primary Health Care / Q000379:methods* / Q000458:organization & administration; D011446:Prospective Studies; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D013689:Telephone; D014218:Triage / Q000592:standards; D055815:Young Adult
keywords: Denmark; after-hours care; appropriateness; efficiency; primary health care; telephone triage