Possible associations between callers’ degree-of-worry and their socioeconomic status when contacting out-of-hours services: a prospective cohort study

Abstract Background Telephone triage within out-of-hours (OOH) services aims to ascertain the urgency of a caller’s medical condition in order to determine the correct type of health care needed, ensuring patient safety. To improve the triage process by increasing patient-centred communication, a tr...

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Main Authors: Sita LeBlanc Thilsted, Fredrik Folke, Janne S. Tolstrup, Lau Caspar Thygesen, Hejdi Gamst-Jensen
Format: Article
Language:English
Published: BMC 2021-04-01
Series:BMC Emergency Medicine
Subjects:
Online Access:https://doi.org/10.1186/s12873-021-00452-0
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author Sita LeBlanc Thilsted
Fredrik Folke
Janne S. Tolstrup
Lau Caspar Thygesen
Hejdi Gamst-Jensen
author_facet Sita LeBlanc Thilsted
Fredrik Folke
Janne S. Tolstrup
Lau Caspar Thygesen
Hejdi Gamst-Jensen
author_sort Sita LeBlanc Thilsted
collection DOAJ
description Abstract Background Telephone triage within out-of-hours (OOH) services aims to ascertain the urgency of a caller’s medical condition in order to determine the correct type of health care needed, ensuring patient safety. To improve the triage process by increasing patient-centred communication, a triage tool has been developed, whereby callers are asked to rate their degree-of-worry (DOW) as a measure of self-evaluated urgency. Studies show that low socioeconomic status (SES), being single and non-Western ethnicity are associated to low self-rated health and high morbidity and these factors may also be associated with high DOW. The aim of this paper was to examine if low SES, being single and non-Western ethnicity were associated to high DOW of callers contacting OOH services. Methods A prospective cohort study design, at the OOH services for the Capital Region of Denmark. Over 2 weeks, 6869 of 38,787 callers met the inclusion criteria: ≥18 years, patients themselves or close relative/friend, reported DOW, had a valid personal identification number and gave informed consent. Callers were asked to report their DOW (1 = minimal worry to 5 = maximal worry), which was dichotomized into low (1–3) and high (4, 5) DOW and linked to data from electronical medical records and Statistics Denmark. Socioeconomic factors (education and annual household income), marital status and ethnicity were assessed in relation to DOW by logistic regression. Results High DOW was reported by 38.2% of the participants. Low SES (low educational level; OR 1.5, 95% CI 1.3–1.7 and low annual household income; 1.5, 1.3–1.6) was associated with high DOW and so too was being single; 1.2, 1.1–1.3 and of non-Western ethnicity; 2.9, 2.5–3.4. Conclusions Knowledge of the association of low SES, marital status as single and non-Western ethnicity with high DOW among callers to OOH services may give call handlers a better understanding of callers’ DOW. If this does not correspond to the call handler’s perception of urgency, this knowledge may further encourage patient-centred communication, aid the triage process and increase patient safety. A better understanding of socioeconomic variables and their relation to callers’ DOW gives direction for future research to improve telephone triage of OOH services.
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spelling doaj.art-bbdb290fc662498c83e995b4ce27a1282022-12-21T22:28:13ZengBMCBMC Emergency Medicine1471-227X2021-04-012111810.1186/s12873-021-00452-0Possible associations between callers’ degree-of-worry and their socioeconomic status when contacting out-of-hours services: a prospective cohort studySita LeBlanc Thilsted0Fredrik Folke1Janne S. Tolstrup2Lau Caspar Thygesen3Hejdi Gamst-Jensen4Copenhagen Emergency Medical Services, University of CopenhagenCopenhagen Emergency Medical Services, University of CopenhagenNational Institute of Public Health, University of Southern DenmarkNational Institute of Public Health, University of Southern DenmarkCopenhagen Emergency Medical Services, University of CopenhagenAbstract Background Telephone triage within out-of-hours (OOH) services aims to ascertain the urgency of a caller’s medical condition in order to determine the correct type of health care needed, ensuring patient safety. To improve the triage process by increasing patient-centred communication, a triage tool has been developed, whereby callers are asked to rate their degree-of-worry (DOW) as a measure of self-evaluated urgency. Studies show that low socioeconomic status (SES), being single and non-Western ethnicity are associated to low self-rated health and high morbidity and these factors may also be associated with high DOW. The aim of this paper was to examine if low SES, being single and non-Western ethnicity were associated to high DOW of callers contacting OOH services. Methods A prospective cohort study design, at the OOH services for the Capital Region of Denmark. Over 2 weeks, 6869 of 38,787 callers met the inclusion criteria: ≥18 years, patients themselves or close relative/friend, reported DOW, had a valid personal identification number and gave informed consent. Callers were asked to report their DOW (1 = minimal worry to 5 = maximal worry), which was dichotomized into low (1–3) and high (4, 5) DOW and linked to data from electronical medical records and Statistics Denmark. Socioeconomic factors (education and annual household income), marital status and ethnicity were assessed in relation to DOW by logistic regression. Results High DOW was reported by 38.2% of the participants. Low SES (low educational level; OR 1.5, 95% CI 1.3–1.7 and low annual household income; 1.5, 1.3–1.6) was associated with high DOW and so too was being single; 1.2, 1.1–1.3 and of non-Western ethnicity; 2.9, 2.5–3.4. Conclusions Knowledge of the association of low SES, marital status as single and non-Western ethnicity with high DOW among callers to OOH services may give call handlers a better understanding of callers’ DOW. If this does not correspond to the call handler’s perception of urgency, this knowledge may further encourage patient-centred communication, aid the triage process and increase patient safety. A better understanding of socioeconomic variables and their relation to callers’ DOW gives direction for future research to improve telephone triage of OOH services.https://doi.org/10.1186/s12873-021-00452-0Decision support systemsEmergency medicineTelephone hotlinesTriagePatient-centred careDecision making
spellingShingle Sita LeBlanc Thilsted
Fredrik Folke
Janne S. Tolstrup
Lau Caspar Thygesen
Hejdi Gamst-Jensen
Possible associations between callers’ degree-of-worry and their socioeconomic status when contacting out-of-hours services: a prospective cohort study
BMC Emergency Medicine
Decision support systems
Emergency medicine
Telephone hotlines
Triage
Patient-centred care
Decision making
title Possible associations between callers’ degree-of-worry and their socioeconomic status when contacting out-of-hours services: a prospective cohort study
title_full Possible associations between callers’ degree-of-worry and their socioeconomic status when contacting out-of-hours services: a prospective cohort study
title_fullStr Possible associations between callers’ degree-of-worry and their socioeconomic status when contacting out-of-hours services: a prospective cohort study
title_full_unstemmed Possible associations between callers’ degree-of-worry and their socioeconomic status when contacting out-of-hours services: a prospective cohort study
title_short Possible associations between callers’ degree-of-worry and their socioeconomic status when contacting out-of-hours services: a prospective cohort study
title_sort possible associations between callers degree of worry and their socioeconomic status when contacting out of hours services a prospective cohort study
topic Decision support systems
Emergency medicine
Telephone hotlines
Triage
Patient-centred care
Decision making
url https://doi.org/10.1186/s12873-021-00452-0
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