Medical telephone triage and patient behaviour: How do they compare?

In the medical call centre Medi-24, medical experts advise people with health problems on the optimal treatment. The purpose of the first part of this study was to answer two questions: To what extend do callers and medical experts differ in their judgement of a health problem, and to what degree are patients compliant to experts' advice.

834 callers were selected for study inclusion. At the call centre, study participants were asked about their intended behaviour prior to the call and approximately 90% of these were interviewed one week later about their subsequent behaviour following the call. The standardised data were analysed fitting a logistic regression model.

61% of callers had not intended to behave the way they were subsequently advised to do. The compliance rate after the triage call was 56%. Non-compliance was largely due to the caller's recollection errors or to a change in the perceived intensity of the health problem. Advice on self-care resulted in an above average compliance. A high compliance was also found when the advice on emergency treatment coincided with the patient's own intended emergency treatment.

The high compliance for the self-care advice showed that patients could be persuaded by the Medi-24 service that professional health care was not necessary. It appeared more difficult to persuade those patients to make an emergency consultation who had initially not intended to do so.