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":"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。","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":"<p><strong>Background and importance: </strong>Telephone calls are often patients' first healthcare service contact, outcomes associated with waiting times are unknown.</p><p><strong>Objectives: </strong>Examine the association between waiting time to answer for a medical helpline and 1- and 30-day mortality.</p><p><strong>Design, setting and participants: </strong>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.</p><p><strong>Exposure: </strong>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.</p><p><strong>Outcome measures and analysis: </strong>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.</p><p><strong>Main results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","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":"{\"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\":\"<p><strong>Background and importance: </strong>Telephone calls are often patients' first healthcare service contact, outcomes associated with waiting times are unknown.</p><p><strong>Objectives: </strong>Examine the association between waiting time to answer for a medical helpline and 1- and 30-day mortality.</p><p><strong>Design, setting and participants: </strong>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.</p><p><strong>Exposure: </strong>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.</p><p><strong>Outcome measures and analysis: </strong>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.</p><p><strong>Main results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"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}","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}
Association between mortality and phone-line waiting time for non-urgent medical care: a Danish registry-based cohort study.
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.
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.
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