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Urban Wisconsin pediatric patients using an after-hours telephone triage service: outcomes and compliance
S J Frisbee1, M Malloy, J R Meurer
1Children's Hospital of Wisconsin, 9000 W Wisconsin Ave, PO Box 1997, MS #950, Milwaukee, WI 53201-1997, USA.
Insights
A telephone triage service (TTS) effectively assesses illness severity in urban pediatric patients. Patient compliance with medical advice was reasonable, suggesting TTS can improve care quality and reduce costs.
Area of Science:
- Pediatric Healthcare
- Health Services Research
Background:
- Telephone triage services (TTS) are increasingly utilized in pediatric healthcare settings.
- Assessing the effectiveness of TTS in evaluating illness acuity and patient compliance is crucial for optimizing healthcare delivery.
- Urban academic pediatric clinics serve diverse populations with specific healthcare needs.
Purpose of the Study:
- To evaluate the capability of a telephone triage service (TTS) to accurately assess illness acuity in pediatric patients.
- To determine patient compliance rates with the advice provided by the TTS.
- To explore the potential benefits of TTS in managing care quality and costs for an urban pediatric population.
Main Methods:
- Retrospective, observational study design.
- Inclusion of patients from an urban, academic, pediatric clinic who utilized the TTS.
- Analysis of patient outcomes and medical encounter data following TTS calls.
Main Results:
- The study population primarily consisted of African-American children under age 5, enrolled in Medicaid HMOs.
- Common reasons for calls included fever, asthma, and HMO authorization.
- The most frequent dispositions were homecare and pediatric emergency department (PED) referrals, with an overall compliance rate of 60%.
- Importantly, no patient initially advised for non-emergent care subsequently required urgent or emergent medical attention.
Conclusions:
- The TTS demonstrated effectiveness in evaluating illness acuity within an urban pediatric population.
- Patient compliance with TTS recommendations was found to be reasonable.
- Implementing a TTS may offer substantial advantages in ensuring healthcare quality and managing costs for this demographic.
Objective:
Evaluate the ability of a telephone triage service (TTS) to assess illness acuity of and patient compliance with advice given.
Design:
Retrospective, observational study.
Patients:
Patients of an urban, academic, pediatric clinic whose parents or caregivers called the TTS between July 23, 1997 and August 23, 1997.
Outcome Measures:
Patient outcomes and visit information at related medical encounters subsequent to a TTS call.
Results:
Patients were primarily African-American, under age 5, enrolled in a Medicaid HMO, and most often called for fever, HMO authorization, or asthma. Homecare and PED referrals were the two most frequent dispositions; overall compliance rate was 60%. No patient referred for non-emergent care required care on an urgent or emergent basis.
Conclusions:
Initial results suggest that the TTS can effectively evaluate illness acuity in an urban population and compliance with advice is reasonable. A TTS may offer significant benefits to ensure care quality and contain costs in this population.