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Emergency department referrals from a provincial medical call centre: Is it more than just 1-800-go-to-emerg?

  • Jonathon Nataraj (a1), James Stempien (a1), Stuart Netherton (a1), Mark Yosri Wahba (a1) and Taofiq Olusegun Oyedokun (a1)...

Abstract

Objective

HealthLine is Saskatchewan's provincial 24-hour health information and support telephone line. A proportion of HealthLine's callers are referred to the emergency department (ED) for further assessment. The purpose of this study was to gain insight into the appropriateness of these referrals and assess whether they increased the burden on an already strained ED system.

Methods

A list of callers referred from HealthLine to Saskatoon EDs from January 1, 2014, to March 31, 2014 was obtained. This list was cross-referenced with Saskatoon Health Region registration data to determine which of those callers had been registered in one of the three Saskatoon EDs within 48 hours of the original call.

Results

During the 90-day time period in question, 707/3,938 (17.9%) of callers were referred by HealthLine to the ED. Out of those referred, 601 were identifiable and 358 attended the ED. Hospital charts were pulled for full data extraction and analysis of the 276 who met inclusion criteria. Of those who presented to the ED and met inclusion criteria, 60% had investigations performed while 66% received some form of treatment. The overall admission rate for the patient population studied was 12.0% v. 16% for non-referred patients. Referred pediatric patients had fewer investigations and treatments with a lower admission rate compared with the adult patients.

Conclusion

The Saskatchewan HealthLine is doing an effective job at directing callers both to and away from EDs in Saskatoon and not overburdening our local EDs with unnecessary referrals.

Objectif

Le service téléphonique provincial d'information sur la santé et de soutien aux appelants en Saskatchewan, HealthLine (l’équivalent d'Info-Santé), est disponible 24 heures sur 24, et un certain nombre de ces appelants sont dirigés vers les services des urgences pour évaluation. L’étude avait donc pour buts d'examiner la pertinence des aiguillages et d’évaluer s'ils avaient pour effet de surcharger un système de services des urgences déjà soumis à rude épreuve.

Méthode

Une liste d'appelants dirigés par le service HealthLine vers les SU de Saskatoon, du 1er janvier au 31 mars 2014, a été transmise à l’équipe de recherche. Celle-ci a, par la suite, procédé à des recoupements avec des données d'inscription provenant de la région sanitaire de Saskatoon afin de déterminer lesquels, parmi ces appelants, s’étaient inscrits dans l'un des trois SU de Saskatoon, dans les 48 heures suivant l'appel initial.

Résultats

Durant la période à l’étude de 90 jours, 707 appelants sur 3938 (17,9%) ont été dirigés vers un SU par le service HealthLine. Pour 601 d'entre eux, l’équipe disposait de renseignements identificatoires, et 358 se sont effectivement rendus au SU. Il y a eu ensuite extraction de données complètes des dossiers médicaux hospitaliers, dont 276, satisfaisant aux critères de sélection, ont fait l'objet d'analyse. Parmi les appelants qui sont allés au SU et qui répondaient aux critères de sélection, 60% ont été soumis à des examens et 66%, à une forme ou à une autre de traitement. Le taux général d'hospitalisation chez ces patients ainsi dirigés s’élevait à 12,0% contre 16% chez les autres patients. Quant aux enfants orientés vers le SU, ils ont subi moins d'examens et moins de traitements que les adultes; il en allait de même pour le taux d'hospitalisation qui était moins élevé.

Conclusion

Le service HealthLine en Saskatchewan effectue son travail d'une manière efficace lorsqu'il dirige les malades vers les SU à Saskatoon, et les aiguillages n'ont pas pour effet de surcharger les SU locaux avec des consultations inutiles.

Copyright

Corresponding author

Correspondence to: Taofiq Olusegun Oyedokun, University of Saskatchewan, Department of Emergency Medicine, Rm 2646, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8; Email: segunoyedo@yahoo.ca

References

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Emergency department referrals from a provincial medical call centre: Is it more than just 1-800-go-to-emerg?

  • Jonathon Nataraj (a1), James Stempien (a1), Stuart Netherton (a1), Mark Yosri Wahba (a1) and Taofiq Olusegun Oyedokun (a1)...

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