Association between mortality and phone-line waiting time for non-urgent medical care: a Danish registry-based cohort study.

IF 3.1 4区医学 Q1 EMERGENCY MEDICINE

European Journal of Emergency Medicine Pub Date : 2024-04-01 Epub Date: 2023-10-02 DOI:10.1097/MEJ.0000000000001088

Elisabeth Helen Anna Mills, Amalie Lykkemark Møller, Filip Gnesin, Nertila Zylyftari, Britta Jensen, Helle Collatz Christensen, Stig Nikolaj Blomberg, Kristian Hay Kragholm, Gunnar Gislason, Lars Køber, Thomas Gerds, Fredrik Folke, Freddy Lippert, Christian Torp-Pedersen, Mikkel Porsborg Andersen

{"title":"Association between mortality and phone-line waiting time for non-urgent medical care: a Danish registry-based cohort study.","authors":"Elisabeth Helen Anna Mills, Amalie Lykkemark Møller, Filip Gnesin, Nertila Zylyftari, Britta Jensen, Helle Collatz Christensen, Stig Nikolaj Blomberg, Kristian Hay Kragholm, Gunnar Gislason, Lars Køber, Thomas Gerds, Fredrik Folke, Freddy Lippert, Christian Torp-Pedersen, Mikkel Porsborg Andersen","doi":"10.1097/MEJ.0000000000001088","DOIUrl":null,"url":null,"abstract":"Background and importance: Telephone calls are often patients' first healthcare service contact, outcomes associated with waiting times are unknown.Objectives: Examine the association between waiting time to answer for a medical helpline and 1- and 30-day mortality.Design, setting and participants: Registry-based cohort study using phone calls data (January 2014 to December 2018) to the Capital Region of Denmark's medical helpline. The service refers to hospital assessment/treatment, dispatches ambulances, or suggests self-care guidance.Exposure: Waiting time was grouped into the following time intervals in accordance with political service targets for waiting time in the Capital Region: <30 s, 0:30-2:59, 3-9:59, and ≥10 min.Outcome measures and analysis: The association between time intervals and 1- and 30-day mortality per call was calculated using logistic regression with strata defined by age and sex.Main results: In total, 1 244 252 callers were included, phoning 3 956 243 times, and 78% of calls waited <10 min. Among callers, 30-day mortality was 1% (16 560 deaths). For calls by females aged 85-110 30-day mortality increased with longer waiting time, particularly within the first minute: 9.6% for waiting time <30 s, 10.8% between 30 s and 1 minute and 9.1% between 1 and 2 minutes. For calls by males aged 85-110 30-day mortality was 11.1%, 12.9% and 11.1%, respectively. Additionally, among calls with a Charlson score of 2 or higher, longer waiting times were likewise associated with increased mortality. For calls by females aged 85-110 30-day mortality was 11.6% for waiting time <30 s, 12.9% between 30 s and 1 minute and 11.2% between 1 and 2 minutes. For calls by males aged 85-110 30-day mortality was 12.7%, 14.1% and 12.6%, respectively. Fewer ambulances were dispatched with longer waiting times (4%/2%) with waiting times <30 s and >10 min.Conclusion: Longer waiting times for telephone contact to a medical helpline were associated with increased 1- and 30-day mortality within the first minute, especially among elderly or more comorbid callers.","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":" ","pages":"127-135"},"PeriodicalIF":3.1000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Emergency Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/MEJ.0000000000001088","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/10/2 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}

引用次数: 0

Abstract

Background and importance: Telephone calls are often patients' first healthcare service contact, outcomes associated with waiting times are unknown.

Objectives: Examine the association between waiting time to answer for a medical helpline and 1- and 30-day mortality.

Design, setting and participants: Registry-based cohort study using phone calls data (January 2014 to December 2018) to the Capital Region of Denmark's medical helpline. The service refers to hospital assessment/treatment, dispatches ambulances, or suggests self-care guidance.

Exposure: Waiting time was grouped into the following time intervals in accordance with political service targets for waiting time in the Capital Region: <30 s, 0:30-2:59, 3-9:59, and ≥10 min.

Outcome measures and analysis: The association between time intervals and 1- and 30-day mortality per call was calculated using logistic regression with strata defined by age and sex.

Main results: In total, 1 244 252 callers were included, phoning 3 956 243 times, and 78% of calls waited <10 min. Among callers, 30-day mortality was 1% (16 560 deaths). For calls by females aged 85-110 30-day mortality increased with longer waiting time, particularly within the first minute: 9.6% for waiting time <30 s, 10.8% between 30 s and 1 minute and 9.1% between 1 and 2 minutes. For calls by males aged 85-110 30-day mortality was 11.1%, 12.9% and 11.1%, respectively. Additionally, among calls with a Charlson score of 2 or higher, longer waiting times were likewise associated with increased mortality. For calls by females aged 85-110 30-day mortality was 11.6% for waiting time <30 s, 12.9% between 30 s and 1 minute and 11.2% between 1 and 2 minutes. For calls by males aged 85-110 30-day mortality was 12.7%, 14.1% and 12.6%, respectively. Fewer ambulances were dispatched with longer waiting times (4%/2%) with waiting times <30 s and >10 min.

Conclusion: Longer waiting times for telephone contact to a medical helpline were associated with increased 1- and 30-day mortality within the first minute, especially among elderly or more comorbid callers.

查看原文本刊更多论文

死亡率与非紧急医疗服务电话线等待时间之间的关系：一项基于丹麦注册的队列研究。

背景和重要性：电话通常是患者的第一次医疗服务联系，与等待时间相关的结果未知。目的：研究医疗求助热线的等待时间与1天和30天死亡率之间的关系。设计、设置和参与者：基于注册的队列研究，使用丹麦首都地区医疗求助热线的电话数据（2014年1月至2018年12月）。该服务指的是医院评估/治疗、派遣救护车或建议自我护理指导。暴露：根据首都地区等待时间的政治服务目标，等待时间分为以下时间间隔：结果测量和分析：使用逻辑回归计算时间间隔与每次呼叫1天和30天死亡率之间的关系，分层由年龄和性别定义。主要结果：共1 244 252名来电者，拨打3 956 243次，78%的电话等待10次分钟。结论：等待电话联系医疗热线的时间越长，第一分钟内1天和30天的死亡率就会增加，尤其是在老年人或合并症患者中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

European Journal of Emergency Medicine 医学-急救医学

CiteScore

3.60

自引率

27.30%

发文量

180

审稿时长

6-12 weeks

期刊介绍： The European Journal of Emergency Medicine is the official journal of the European Society for Emergency Medicine. It is devoted to serving the European emergency medicine community and to promoting European standards of training, diagnosis and care in this rapidly growing field. Published bimonthly, the Journal offers original papers on all aspects of acute injury and sudden illness, including: emergency medicine, anaesthesiology, cardiology, disaster medicine, intensive care, internal medicine, orthopaedics, paediatrics, toxicology and trauma care. It addresses issues on the organization of emergency services in hospitals and in the community and examines postgraduate training from European and global perspectives. The Journal also publishes papers focusing on the different models of emergency healthcare delivery in Europe and beyond. With a multidisciplinary approach, the European Journal of Emergency Medicine publishes scientific research, topical reviews, news of meetings and events of interest to the emergency medicine community. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.