School of Health and Related Research, The University of Sheffield, Sheffield, UK
School of Health and Related Research, The University of Sheffield, Sheffield, UK.
BMJ Open. 2022 Jul 12;12(7):e058964. doi: 10.1136/bmjopen-2021-058964.
To explore what impact introducing the National Health Service (NHS) 111 online service had on the number of phone calls to the NHS 111 telephone service and the NHS urgent care system.
Observational study using a dose-response interrupted time series model and random-effects meta- analysis to estimate the average effect.
NHS 111 telephone and online contacts for 18 NHS 111 area codes in England. NHS 111 telephone and online contacts data were collected between October 2010 to December 2019 and January 2018 to December 2019, respectively.
Primary outcome: the number of triaged calls to the NHS 111 telephone service following the introduction of NHS 111 online.
total calls to the NHS 111 telephone service, total number of emergency ambulance referrals or advice to contact 999, total number of advice to attend an emergency department or other urgent care treatment facility, and total number of advice to contact primary care.
For triaged calls, the overall incidence rate ratio (IRR) per 1000 online contacts was 1.013 (95% CI: 0.996 to 1.029, p=0.127). For total calls, the overall IRR per 1000 online contacts was 1.008 (95% CI: 0.992 to 1.025, p=0.313). For emergency ambulance referrals or advice to contact 999, the overall IRR per 1000 online contacts was 1.067 (95% CI: 1.035 to 1.100, p<0.001). For advice to attend an emergency department or other urgent care treatment facility, the overall IRR per 1000 online contacts is 1.050 (95% CI: 1.010 to 1.092, p=0.014). And finally, for those advised to contact primary care, the overall IRR per 1000 online contacts is 1.051 (95% CI: 1.027 to 1.076, p<0.001).
It was found that the NHS 111 online service has little impact on the number of triaged and total calls, suggesting that the workload for the NHS 111 telephone service has not increased or decreased as a result of introducing NHS 111 online. However, there was evidence to suggest an increase in the overall number of disposition recommendations (ambulance, emergency department and primary care) for NHS 111 telephone and online services combined following the introduction of the NHS 111 online service.
探讨引入国民保健服务（NHS）111 在线服务对 NHS 111 电话服务和国民保健紧急护理系统的电话数量的影响。
使用剂量反应中断时间序列模型和随机效应荟萃分析来估计平均效应的观察性研究。
英格兰 18 个 NHS 111 区号的 NHS 111 电话和在线联系方式。 NHS 111 电话和在线联系方式数据分别于 2010 年 10 月至 2019 年 12 月和 2018 年 1 月至 2019 年 12 月收集。
主要结果： NHS 111 在线服务推出后，NHS 111 电话服务中分诊电话的数量。
NHS 111 电话服务的总来电数、紧急救护车转诊或建议拨打 999 的总数、建议前往急诊部门或其他紧急护理治疗设施的总数，以及建议联系初级保健的总数。
对于分诊电话，每 1000 次在线联系的总发生率比（IRR）为 1.013（95%置信区间：0.996 至 1.029，p=0.127）。对于总来电数，每 1000 次在线联系的总 IRR 为 1.008（95%置信区间：0.992 至 1.025，p=0.313）。对于紧急救护车转诊或建议拨打 999 的电话，每 1000 次在线联系的总 IRR 为 1.067（95%置信区间：1.035 至 1.100，p<0.001）。对于建议前往急诊部门或其他紧急护理治疗设施的电话，每 1000 次在线联系的总 IRR 为 1.050（95%置信区间：1.010 至 1.092，p=0.014）。最后，对于建议联系初级保健的电话，每 1000 次在线联系的总 IRR 为 1.051（95%置信区间：1.027 至 1.076，p<0.001）。
研究发现 NHS 111 在线服务对分诊和总来电数量的影响不大，这表明引入 NHS 111 在线服务并未导致 NHS 111 电话服务的工作量增加或减少。然而，有证据表明，在引入 NHS 111 在线服务后，NHS 111 电话和在线服务的总体处置建议（救护车、急诊部门和初级保健）数量有所增加。
