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.
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.
Originalsprog | Engelsk |
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Tidsskrift | European Journal of Emergency Medicine |
Vol/bind | 31 |
Udgave nummer | 2 |
Sider (fra-til) | 127-135 |
Antal sider | 9 |
ISSN | 0969-9546 |
DOI | |
Status | Udgivet - 2024 |
Bibliografisk note
Funding Information:This study was supported by grant number R122-A8403, from the Danish Heart Foundation.
Funding Information:
Dr. Zylyftari has received funding from the European Union´s Horizon 2020 research and innovation program ESCAPE-NET and Helsefonden not related to this study. Dr. Kragholm has received a research grant from the Laerdal Foundation. Dr. Gislason has received funding from the European Union’s Horizon 2020 research and innovation program ESCAPE-NET. Dr. Køber reports grants from Novo Nordisk, AstraZeneca, Novartis and Boehringer outside the submitted work. Dr.Folke has received research grants from the TrygFoundation, Denmark, the Novo Nordisk Foundation, Denmark, and the Laerdal Foundation, Norway. Dr. Torp-Pedersen has received research grants from Bayer and Novo Nordisk outside the submitted work. For the remaining authors, there are no conflicts of interest.
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