Njeru Jane W, Damodaran Swathi, North Frederick, Jacobson Debra J, Wilson Patrick M, St Sauver Jennifer L, Radecki Breitkopf Carmen, Wieland Mark L
Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Mayo Medical School, Mayo Clinic College of Medicine, Rochester, MN, USA.
BMC Health Serv Res. 2017 Nov 9;17(1):706. doi: 10.1186/s12913-017-2651-z.
Communication between patients with limited English proficiency (LEP) and telephone triage services has not been previously explored. The purpose of this study was to determine the utilization characteristics of a primary care triage call center by patients with LEP.
This was a retrospective cohort study of the utilization of a computer-aided, nurse-led telephone triage system by English proficiency status of patients empaneled to a large primary care practice network in the Midwest United States. Interpreter Services (IS) need was used as a proxy for LEP.
Call volumes between the 587 adult patients with LEP and an age-frequency matched cohort of English-Proficient (EP) patients were similar. Calls from patients with LEP were longer and more often made by a surrogate. Patients with LEP received recommendations for higher acuity care more frequently (49.4% versus 39.0%; P < 0.0004), and disagreed with recommendations more frequently (30.1% versus 20.9%; P = 0.0004). These associations remained after adjustment for comorbidities. Patients with LEP were also less likely to follow recommendations (60.9% versus 69.4%; P = 0.0029), even after adjusting for confounders (adjusted odds ratio [AOR] = 0.65; 95% confidence interval [CI], 0.49, 0.85; P < 0.001).
Patients with LEP who utilized a computer-aided, nurse-led telephone triage system were more likely to receive recommendations for higher acuity care compared to EP patients. They were also less likely to agree with, or follow, recommendations given. Additional research is needed to better understand how telephone triage can better serve patients with LEP.
此前尚未探讨过英语水平有限（LEP）的患者与电话分诊服务之间的沟通情况。本研究的目的是确定LEP患者对初级保健分诊呼叫中心的使用特征。
这是一项回顾性队列研究，根据美国中西部一个大型初级保健实践网络中患者的英语水平状况，对计算机辅助、护士主导的电话分诊系统的使用情况进行研究。将口译服务需求用作LEP的替代指标。
587名LEP成年患者与年龄-频率匹配的英语熟练（EP）患者队列之间的呼叫量相似。LEP患者的通话时间更长，且更多由代理人拨打。LEP患者更频繁地收到更高 acuity 护理的建议（49.4% 对 39.0%；P < 0.0004），并且更频繁地不同意建议（30.1% 对 20.9%；P = 0.0004）。在对合并症进行调整后，这些关联仍然存在。即使在对混杂因素进行调整后，LEP患者也不太可能遵循建议（60.9% 对 69.4%；P = 0.0029）（调整后的优势比[AOR] = 0.65；95% 置信区间[CI]，0.49，0.85；P < 0.001）。
与EP患者相比，使用计算机辅助、护士主导的电话分诊系统的LEP患者更有可能收到更高 acuity 护理的建议。他们也不太可能同意或遵循所给出的建议。需要进一步研究以更好地了解电话分诊如何能更好地为LEP患者服务。
