Observational study of the implementation of telephone advice nursing in Sweden: did callers follow recommendations and did the rate of healthcare visits change?
Objectives Telephone advice nursing is introduced in many countries with one key aim being a reduction of avoidable healthcare visits. The aim of this study was to explore whether callers to a telephone advice nursing service followed the telenurses’ recommendations, and whether there was a change i...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2021-08-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/11/8/e051233.full |
| _version_ | 1819008263645036544 |
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| author | Niklas Zethraeus Korinna Karampampa Amanda Sundberg Anna Carin Wahlberg |
| author_facet | Niklas Zethraeus Korinna Karampampa Amanda Sundberg Anna Carin Wahlberg |
| author_sort | Niklas Zethraeus |
| collection | DOAJ |
| description | Objectives Telephone advice nursing is introduced in many countries with one key aim being a reduction of avoidable healthcare visits. The aim of this study was to explore whether callers to a telephone advice nursing service followed the telenurses’ recommendations, and whether there was a change in the level and trend of the rate of healthcare visits after the introduction of telephone advice nursing.Design Observational study.Setting Primary and secondary care in Jönköping Region, Sweden.Participants Telephone advice nursing calls, 6:00–23:00, 2014–2015 (n=185 994) and outpatient healthcare visits 2012–2015 (n=6 877 266).Primary outcome Proportion of callers who visited healthcare within the time period advised by the telenurse.Secondary outcome Change in level or trend of the overall rate of healthcare visits per 1000 persons and 4-week period after the introduction of telephone advice nursing, with subgroup analysis for primary and secondary care.Results 77% of callers who were recommended either to visit healthcare within 24 hours or to ‘wait and see’ followed the recommendations. There was no significant change in level (−5.15; 95% CI −15.80 to 5.50; p=0.349) or trend (−0.24; 95% CI −0.86 to 0.38; p=0.448) of the overall rate of visits per 1000 persons and 4-week period after the introduction of telephone advice nursing. For the rate of primary care visits, an increase in level (8.01; 95% CI 6.36 to 9.66; p<0.001) and trend (1.28; 95% CI 1.17 to 1.39; p<0.001) were observed. For the rate of secondary care visits, a decrease in level (−8.77, 95% CI −14.41 to −3.13; p=0.004) and trend (−1.03, 95% CI −1.35 to −0.71; p<0.001) were observed.Conclusions The introduction of telephone advice nursing may have contributed to a shift in the rate of healthcare visits from secondary to primary care. |
| first_indexed | 2024-12-21T00:37:42Z |
| format | Article |
| id | doaj.art-840c2ab01be64d3b80fa386d000d5856 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-12-21T00:37:42Z |
| publishDate | 2021-08-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-840c2ab01be64d3b80fa386d000d58562022-12-21T19:21:45ZengBMJ Publishing GroupBMJ Open2044-60552021-08-0111810.1136/bmjopen-2021-051233Observational study of the implementation of telephone advice nursing in Sweden: did callers follow recommendations and did the rate of healthcare visits change?Niklas Zethraeus0Korinna Karampampa1Amanda Sundberg2Anna Carin Wahlberg33Department of LIME, Karolinska Institutet, Stockholm, SwedenDivision of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171-77 Stockholm, SwedenDepartment of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, SwedenDepartment of Neurobiology, Care sciences and Society, Karolinska Institutet, Stockholm, SwedenObjectives Telephone advice nursing is introduced in many countries with one key aim being a reduction of avoidable healthcare visits. The aim of this study was to explore whether callers to a telephone advice nursing service followed the telenurses’ recommendations, and whether there was a change in the level and trend of the rate of healthcare visits after the introduction of telephone advice nursing.Design Observational study.Setting Primary and secondary care in Jönköping Region, Sweden.Participants Telephone advice nursing calls, 6:00–23:00, 2014–2015 (n=185 994) and outpatient healthcare visits 2012–2015 (n=6 877 266).Primary outcome Proportion of callers who visited healthcare within the time period advised by the telenurse.Secondary outcome Change in level or trend of the overall rate of healthcare visits per 1000 persons and 4-week period after the introduction of telephone advice nursing, with subgroup analysis for primary and secondary care.Results 77% of callers who were recommended either to visit healthcare within 24 hours or to ‘wait and see’ followed the recommendations. There was no significant change in level (−5.15; 95% CI −15.80 to 5.50; p=0.349) or trend (−0.24; 95% CI −0.86 to 0.38; p=0.448) of the overall rate of visits per 1000 persons and 4-week period after the introduction of telephone advice nursing. For the rate of primary care visits, an increase in level (8.01; 95% CI 6.36 to 9.66; p<0.001) and trend (1.28; 95% CI 1.17 to 1.39; p<0.001) were observed. For the rate of secondary care visits, a decrease in level (−8.77, 95% CI −14.41 to −3.13; p=0.004) and trend (−1.03, 95% CI −1.35 to −0.71; p<0.001) were observed.Conclusions The introduction of telephone advice nursing may have contributed to a shift in the rate of healthcare visits from secondary to primary care.https://bmjopen.bmj.com/content/11/8/e051233.full |
| spellingShingle | Niklas Zethraeus Korinna Karampampa Amanda Sundberg Anna Carin Wahlberg Observational study of the implementation of telephone advice nursing in Sweden: did callers follow recommendations and did the rate of healthcare visits change? BMJ Open |
| title | Observational study of the implementation of telephone advice nursing in Sweden: did callers follow recommendations and did the rate of healthcare visits change? |
| title_full | Observational study of the implementation of telephone advice nursing in Sweden: did callers follow recommendations and did the rate of healthcare visits change? |
| title_fullStr | Observational study of the implementation of telephone advice nursing in Sweden: did callers follow recommendations and did the rate of healthcare visits change? |
| title_full_unstemmed | Observational study of the implementation of telephone advice nursing in Sweden: did callers follow recommendations and did the rate of healthcare visits change? |
| title_short | Observational study of the implementation of telephone advice nursing in Sweden: did callers follow recommendations and did the rate of healthcare visits change? |
| title_sort | observational study of the implementation of telephone advice nursing in sweden did callers follow recommendations and did the rate of healthcare visits change |
| url | https://bmjopen.bmj.com/content/11/8/e051233.full |
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