Freiermuth Mélanie, Newman Christopher J, Villoslada Judit
Faculty of Biology and Medicine, University of Lausanne, 1011 Lausanne, Switzerland.
Paediatric Neurology and Neurorehabilitation Unit, Lausanne University Hospital, 1011 Lausanne, Switzerland.
Children (Basel). 2023 Jan 18;10(2):179. doi: 10.3390/children10020179.
Medical call centres can evaluate and refer patients to an emergency department (ED), a physician or provide guidance for self-care. Our aim was (1) to determine parental adherence to an ED orientation after being referred by the nurses of a call centre, (2) to observe how adherence varies according to children's characteristics and (3) to assess parents' reasons for non-adherence. This was a prospective cohort study set in the Lausanne agglomeration, Switzerland. From 1 February to 5 March 2022, paediatric calls (<16 years old) with an ED orientation were selected. Life-threatening emergencies were excluded. Parental adherence was then verified in the ED. All parents were contacted by telephone to respond to a questionnaire regarding their call. Parental adherence to the ED orientation was 75%. Adherence decreased significantly with increasing distance between the place the call originated and the ED. The child's age, sex and health complaints within calls had no effect on adherence. The three major reasons for non-adherence to telephone referral were: improvement in the child's condition (50.7%), parents' decision to go elsewhere (18.3%) and an appointment with a paediatrician (15.5%). Our results offer new perspectives to optimise the telephone assessment of paediatric patients and decrease barriers to adherence.
医疗呼叫中心可以对患者进行评估，并将其转诊至急诊科、医生处，或提供自我护理指导。我们的目的是：（1）确定家长在接到呼叫中心护士转诊后前往急诊科的依从性；（2）观察依从性如何根据儿童的特征而变化；（3）评估家长不依从的原因。这是一项在瑞士洛桑城市群开展的前瞻性队列研究。在2022年2月1日至3月5日期间，选取了具有转诊至急诊科倾向的儿科呼叫（针对16岁以下儿童）。危及生命的紧急情况被排除在外。随后在急诊科核实家长的依从性。通过电话联系所有家长，让他们回答一份关于此次呼叫的问卷。家长对转诊至急诊科倾向的依从率为75%。随着呼叫发起地与急诊科之间距离的增加，依从性显著下降。呼叫中儿童的年龄、性别和健康问题对依从性没有影响。不依从电话转诊的三大主要原因是：孩子病情好转（50.7%）、家长决定去其他地方（18.3%）以及预约了儿科医生（15.5%）。我们的研究结果为优化儿科患者的电话评估以及减少依从性障碍提供了新的视角。
