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社会人口学和与健康相关的决定因素对拨打医疗热线的重复次数的影响:一项前瞻性队列研究。

Sociodemographic and health-related determinants for making repeated calls to a medical helpline: a prospective cohort study.

机构信息

Emergency Medical Services Copenhagen, Emergency Medical Services Copenhagen, Ballerup, Denmark.

University of Copenhagen Faculty of Health Sciences, Copenhagen, Denmark.

出版信息

BMJ Open. 2019 Aug 23;9(7):e030173. doi: 10.1136/bmjopen-2019-030173.

Abstract

OBJECTIVES

To identify sociodemographic and health-related characteristics of callers' making repeated calls within 48 hours to a medical helpline, compared with those who only call once.

SETTING

In the Capital Region of Denmark people with acute, non-life-threatening illnesses or injuries are triaged through a single-tier medical helpline for acute, healthcare services.

PARTICIPANTS

People who called the medical helpline between 18 January and 9 February 2017 were invited to participate in the survey. During the period, 38 787 calls were handled and 12 902 agreed to participate. Calls were excluded because of the temporary civil registration number (n=78), the call was not made by the patient or a close relative (n=699), or survey responses were incomplete (n=19). Hence, the analysis included 12 106 calls, representing 11.131 callers' making single calls and 464 callers' making two or more calls within 48 hours. Callers' data (age, sex and caller identification) were collected from the medical helpline's electronic records. Data were enriched using the callers' self-rated health, self-evaluated degree of worry, and registry data on income, ethnicity and comorbidities. The OR for making repeated calls was calculated in a crude, sex-adjusted and age-adjusted analysis and in a mutually adjusted analysis.

RESULTS

The crude logistic regression analysis showed that age, self-rated health, self-evaluated degree of worry, income, ethnicity and comorbidities were significantly associated with making repeated calls. In the mutually adjusted analysis associations decreased, however, odds ratios remained significantly decreased for callers with a household income in the middle (OR=0.71;95% CI 0.54 to 0.92) or highest (OR=0.68;95% CI 0.48 to 0.96) quartiles, whereas immigrants had borderline significantly increased OR (OR=1.34;95% CI 0.96 to 1.86) for making repeated calls.

CONCLUSIONS

Findings suggest that income and ethnicity are potential determinants of callers' need to make additional calls within 48 hours to a medical helpline with triage function.

摘要

目的

与仅拨打一次电话的呼叫者相比,确定在 48 小时内反复拨打医疗热线的呼叫者的社会人口学和与健康相关的特征。

背景

在丹麦首都地区,患有急性、非危及生命的疾病或伤害的人通过单一层次的医疗热线接受急性保健服务的分诊。

参与者

2017 年 1 月 18 日至 2 月 9 日期间拨打医疗热线的人被邀请参加调查。在此期间,共处理了 38787 个电话,有 12902 人同意参加。由于临时公民登记号码(n=78)、电话不是由患者或近亲拨打的(n=699)或调查回复不完整(n=19),因此排除了这些电话。因此,分析包括 12106 个电话,代表 11.131 个拨打单次电话的呼叫者和 464 个在 48 小时内拨打两次或更多电话的呼叫者。呼叫者的数据(年龄、性别和呼叫者识别)是从医疗热线的电子记录中收集的。使用呼叫者的自我评估健康状况、自我评估担忧程度以及收入、族裔和合并症的登记数据对数据进行了丰富。在未调整、性别调整和年龄调整分析以及相互调整分析中计算了重复呼叫的优势比。

结果

未调整的逻辑回归分析显示,年龄、自我评估健康状况、自我评估担忧程度、收入、族裔和合并症与重复呼叫显著相关。然而,在相互调整的分析中,关联减少,但具有中等(OR=0.71;95%CI 0.54 至 0.92)或最高(OR=0.68;95%CI 0.48 至 0.96)四分位收入的呼叫者的比值比仍然显著降低,而移民的重复呼叫比值比有边缘显著增加(OR=1.34;95%CI 0.96 至 1.86)。

结论

研究结果表明,收入和族裔是呼叫者在 48 小时内拨打具有分诊功能的医疗热线的额外需求的潜在决定因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e58b/6720138/0a4252cbf70e/bmjopen-2019-030173f01.jpg

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