瑞士非危急紧急情况电话分诊服务的影响：一项横断面研究。

Impact of a telephone triage service for non-critical emergencies in Switzerland: A cross-sectional study.

作者信息

Thierrin Chloé, Augsburger Aurélie, Dami Fabrice, Monney Christophe, Staeger Philippe, Clair Carole

机构信息

Department of Ambulatory Care, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.

Department of Training, Research and Innovation, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.

出版信息

PLoS One. 2021 Apr 2;16(4):e0249287. doi: 10.1371/journal.pone.0249287. eCollection 2021.

DOI:10.1371/journal.pone.0249287

PMID:33798216

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8018644/

Abstract

INTRODUCTION

Telephone triage services (TTS) play an increasing role in the delivery of healthcare. The objective of this study was to characterize the adult users of a TTS for non-critical emergencies, describe the types of advice given and their subsequent observation, and assess the influence of TTS on the use of the healthcare system in a sanitary region of Switzerland.

METHODS

Data from a TTS based in the French part of Switzerland were analyzed. This service consists of a medical contact center for non-critical emergencies, with trained nurses available 24/7. A random selection of 2,034 adult calls was performed between July and December 2018. Research students contacted users 2 to 4 weeks after the initial call and assessed sociodemographic and clinical data, as well as the impact of the advice received on the use of the healthcare system.

RESULTS

A sample of 412 users was included in the analyses. The average age was 49.0 (SD 20.4) years; 68.5% were women and 72.8% of Swiss origin. The two main recommendations provided by nurses were to consult the emergency department (ED) (44.6%, n = 184) and to contact a physician on duty (33.2%, n = 137). The majority of users followed the advice given by the nurses (substantial agreement [k = 0.79] with consulting the ED and perfect agreement [k = 0.87] with contacting a physician on duty). We calculated that calling the TTS could decrease the intention to visit the ED by 28.1%.

CONCLUSION

TTS for non-critical emergencies have the potential to decrease the use of ED services.

摘要

引言

电话分诊服务（TTS）在医疗保健服务中发挥着越来越重要的作用。本研究的目的是描述非危急紧急情况的TTS成年用户特征，说明所提供建议的类型及其后续观察情况，并评估TTS对瑞士某卫生区域医疗系统使用情况的影响。

方法

对瑞士法语区一家TTS的数据进行了分析。该服务包括一个针对非危急紧急情况的医疗联络中心，有经过培训的护士全天候值班。在2018年7月至12月期间随机抽取了2034个成年来电。研究学生在初次来电后的2至4周联系用户，评估社会人口统计学和临床数据，以及所获建议对医疗系统使用情况的影响。

结果

412名用户样本纳入分析。平均年龄为49.0（标准差20.4）岁；68.5%为女性，72.8%为瑞士籍。护士提供的两项主要建议是前往急诊科就诊（44.6%，n = 184）和联系值班医生（33.2%，n = 137）。大多数用户听从了护士的建议（对于前往急诊科就诊有高度一致性[k = 0.79]，对于联系值班医生有完全一致性[k = 0.87]）。我们计算得出，拨打TTS可使前往急诊科就诊的意愿降低28.1%。