Triaje telefónico en medicina domiciliaria: error de clasificación y factores asociados

Abstract

Objective

To determine the frequency of classification error and its associated factors during telephone triage in a home care service.

Design

Cross-sectional observational study.

Site

Regulatory center of a home care service. Medellin Colombia.

Participants

Health care staff of the regulatory center.

Interventions

The records of the telephone calls answered by the assistance personnel during January to June of the year 2020 were evaluated.

Main measurements

Frequency of classification error and characteristics of the telephone call and of the assistance personnel. The factors associated with the classification error were analyzed using a model of generalized estimating equations (GEE).

Results

260 telephone records were analyzed, of which 15.4% (n = 40) presented a classification error, 53.7% of them against the patient (undertriage). Regarding the care staff (n = 58), the median age was 26.5 years (IQR 23-31) and 69% (n = 40) were women. A higher percentage of classification error was found in services requested by people other than the patient (75%; n = 30) and in calls made during the night (42.5%; n = 17). In the multivariate analysis, an association was observed between the patient's complaint and classification error (OR: 2.42, CI95% 1.06-5.53).

Conclusions

Undertriage can generate delays and increase the risk of complications in primary care. It is important to implement training strategies for 4 healthcare personnel to avoid errors during telephone triage and generate a positive impact on patients and the quality of care.