Characteristics and triage in older citizens calling a semi-acute medical helpline in Denmark: a prospective cohort study.

OBJECTIVES

To investigate baseline characteristics associated with older citizens calling the medical helpline 1813 (MH1813) in Denmark and how these baseline characteristics were associated with triage outcomes in a subset population of patients with high degree of worry (DOW).

SETTING

In the Capital Region of Denmark people with acute, non-life-threatening illnesses or injuries are triaged through a single-tier MH1813 for acute healthcare services.

PARTICIPANTS

Participants were gathered from a prospective cohort established between 24 January and 9 February 2017 who called the MH1813. Out of 11,413 citizens, 1525 (13.3%) were elderly (≥ 65 years). Callers' identification, age, sex, and contact with general practitioner (GP) prior to MH1813-call were collected from the medical helpline's records. Data were enriched using the callers' self-rated health, self-evaluated DOW, and registry data on comorbidities.

RESULTS

Forty-two percent of call issues were terminated without any further action. Among 882 triaged to a hospital face-to-face consultation, n = 315 (36%) were admitted and 2/3 discharged directly from the emergency department. Approx. one third of the most worried older callers have had a contact with their GP prior to the MH1813 call. A high level on Charlson Comorbidity Index and high DOW significantly increased risk of admission. Adjusted self-rated health was not significantly associated with admission within the subset group of older self-callers and high DOW. Men more often than women, were referred to face-to-face consultation (46% vs. 37%) and subsequent admission (23% vs. 18%), though potentially explained by a higher comorbidity level in men.

CONCLUSION

The MH1813 triage revealed that older callers were triaged to Face-to-face consultations if they had high DOW or were men representing a higher level of comorbidities than women. The patients' perspectives on being alone, loneliness, rejection of Face-to-face triage, and the re-transition dilemma, needs to be further investigated.