Appropriateness of a Telephone Health Line Referral System in a Pediatric Emergency Department
Main Author: | |
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Publication Date: | 2022 |
Other Authors: | , , , |
Format: | Article |
Language: | eng |
Source: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Download full: | https://doi.org/10.25754/pjp.2022.24770 |
Summary: | Introduction: Telephone health lines have been increasingly gaining popularity, offering healthcare counseling and triage to the population and resolving the need for unnecessary medical evaluations. This study aimed to characterize the health line referral pattern of the pediatric population to the emergency department of a level II hospital and assess its appropriateness. Methods: Cross-sectional investigation of all children referrals using the SNS 24 phone line from July 1st to December 31st, 2019. Good referrals were defined based on performing emergency-department-specific examinations, medication prescriptions, hospital admissions, or transfers. The statistical analysis was performed in SPSS software (version 26). Results: This study included 1080 children with a median age of two years, and the majority of referrals were related to children under the age of three. Furthermore, most good referrals were observed in adolescents (p = 0.001) and most patients were referred between 8 pm and midnight. Cough and nausea or vomiting algorithms were frequently associated with good referrals (p < 0.0001), while rash was commonly associated with poor referrals (p < 0.0001). Only 37.8% of the patients underwent examinations in the emergency department (43.3% were primary-care accessible), 28.3% of the cases required medication in the emergency department, 4.2% of the patients were admitted to hospital care, and 0.4% of the subjects were transferred to another hospital. Viral infectious diseases were the most common discharge diagnosis (52.1%). In addition, over half of the patients did not meet the criteria for a good referral. Discussion: Although phone triage has been believed to be difficult, an excessive number of poor referrals was observed in this study. Accordingly, algorithms should be modified to decrease the chance of unnecessary hospital visits. |
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Appropriateness of a Telephone Health Line Referral System in a Pediatric Emergency DepartmentOriginal articlesIntroduction: Telephone health lines have been increasingly gaining popularity, offering healthcare counseling and triage to the population and resolving the need for unnecessary medical evaluations. This study aimed to characterize the health line referral pattern of the pediatric population to the emergency department of a level II hospital and assess its appropriateness. Methods: Cross-sectional investigation of all children referrals using the SNS 24 phone line from July 1st to December 31st, 2019. Good referrals were defined based on performing emergency-department-specific examinations, medication prescriptions, hospital admissions, or transfers. The statistical analysis was performed in SPSS software (version 26). Results: This study included 1080 children with a median age of two years, and the majority of referrals were related to children under the age of three. Furthermore, most good referrals were observed in adolescents (p = 0.001) and most patients were referred between 8 pm and midnight. Cough and nausea or vomiting algorithms were frequently associated with good referrals (p < 0.0001), while rash was commonly associated with poor referrals (p < 0.0001). Only 37.8% of the patients underwent examinations in the emergency department (43.3% were primary-care accessible), 28.3% of the cases required medication in the emergency department, 4.2% of the patients were admitted to hospital care, and 0.4% of the subjects were transferred to another hospital. Viral infectious diseases were the most common discharge diagnosis (52.1%). In addition, over half of the patients did not meet the criteria for a good referral. Discussion: Although phone triage has been believed to be difficult, an excessive number of poor referrals was observed in this study. Accordingly, algorithms should be modified to decrease the chance of unnecessary hospital visits.Introdução: A linha SNS-24 é um serviço telefónico que oferece conselhos sobre saúde e triagem, de forma a diminuir as avaliações médicas desnecessárias. O objectivo do nosso trabalho será determinar se a referenciação pela linha SNS-24 a um serviço de urgência (SU) pediátrico é adequada. Materiais e Métodos: Realizámos um estudo retrospectivo e estatístico das crianças referenciadas ao SU pela linha SNS-24 entre 1 de julho e 31 de dezembro de 2019. Considerámos uma boa referenciação quando foram realizados exames específicos de um SU, medicação, internamentos ou transferências. A análise estatística foi efectuada com o SPSS V.26. Resultados: Incluímos 1080 crianças no nosso estudo, com uma mediana de idades de dois anos. A maioria das referenciações ocorreu abaixo dos três anos. Constatámos que mais de metade das referenciações não cumpriam critérios de uma boa referenciação, sendo estas últimas mais frequentes em adolescentes (p=0,001). A maioria dos doentes foi referenciado entre as 20h e a meia-noite. Os algoritmos “tosse” e “náuseas e vómitos” foram frequentemente associados a boas referenciações (p<0,0001), contrariamente ao “rash” que foi associado a más referenciações (p<0,0001). Verificou-se que 37,8% dos doentes realizaram algum exame complementar no SU (43,3% dos quais seriam acessíveis nos cuidados de saúde primários), 28,3% realizaram medicação, 4,2% foram internados e 0,4% transferidos para outro hospital. As infecções víricas foram o diagnóstico mais frequente. Conclusão: Apesar da dificuldade e limitações da triagem telefónica, observou-se um número excessivo de más referenciações. Sugerimos modificar ou adaptar algoritmos de modo a diminuir as utilizações desnecessárias dos serviços de saúde. Sociedade Portuguesa de Pediatria2022-05-23info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://doi.org/10.25754/pjp.2022.24770eng2184-44532184-3333Correia de Oliveira, SusanaSousa, PatríciaMachado, SaraPereira, CecíliaSão Simão, Teresainfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-08-03T02:58:20Zoai:ojs.revistas.rcaap.pt:article/24770Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:25:38.837312Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Appropriateness of a Telephone Health Line Referral System in a Pediatric Emergency Department |
title |
Appropriateness of a Telephone Health Line Referral System in a Pediatric Emergency Department |
spellingShingle |
Appropriateness of a Telephone Health Line Referral System in a Pediatric Emergency Department Correia de Oliveira, Susana Original articles |
title_short |
Appropriateness of a Telephone Health Line Referral System in a Pediatric Emergency Department |
title_full |
Appropriateness of a Telephone Health Line Referral System in a Pediatric Emergency Department |
title_fullStr |
Appropriateness of a Telephone Health Line Referral System in a Pediatric Emergency Department |
title_full_unstemmed |
Appropriateness of a Telephone Health Line Referral System in a Pediatric Emergency Department |
title_sort |
Appropriateness of a Telephone Health Line Referral System in a Pediatric Emergency Department |
author |
Correia de Oliveira, Susana |
author_facet |
Correia de Oliveira, Susana Sousa, Patrícia Machado, Sara Pereira, Cecília São Simão, Teresa |
author_role |
author |
author2 |
Sousa, Patrícia Machado, Sara Pereira, Cecília São Simão, Teresa |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Correia de Oliveira, Susana Sousa, Patrícia Machado, Sara Pereira, Cecília São Simão, Teresa |
dc.subject.por.fl_str_mv |
Original articles |
topic |
Original articles |
description |
Introduction: Telephone health lines have been increasingly gaining popularity, offering healthcare counseling and triage to the population and resolving the need for unnecessary medical evaluations. This study aimed to characterize the health line referral pattern of the pediatric population to the emergency department of a level II hospital and assess its appropriateness. Methods: Cross-sectional investigation of all children referrals using the SNS 24 phone line from July 1st to December 31st, 2019. Good referrals were defined based on performing emergency-department-specific examinations, medication prescriptions, hospital admissions, or transfers. The statistical analysis was performed in SPSS software (version 26). Results: This study included 1080 children with a median age of two years, and the majority of referrals were related to children under the age of three. Furthermore, most good referrals were observed in adolescents (p = 0.001) and most patients were referred between 8 pm and midnight. Cough and nausea or vomiting algorithms were frequently associated with good referrals (p < 0.0001), while rash was commonly associated with poor referrals (p < 0.0001). Only 37.8% of the patients underwent examinations in the emergency department (43.3% were primary-care accessible), 28.3% of the cases required medication in the emergency department, 4.2% of the patients were admitted to hospital care, and 0.4% of the subjects were transferred to another hospital. Viral infectious diseases were the most common discharge diagnosis (52.1%). In addition, over half of the patients did not meet the criteria for a good referral. Discussion: Although phone triage has been believed to be difficult, an excessive number of poor referrals was observed in this study. Accordingly, algorithms should be modified to decrease the chance of unnecessary hospital visits. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-05-23 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.25754/pjp.2022.24770 |
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https://doi.org/10.25754/pjp.2022.24770 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
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2184-4453 2184-3333 |
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info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Pediatria |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Pediatria |
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reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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