A study of urgent and emergency referrals from NHS Direct within England
نویسندگان
چکیده
OBJECTIVES The presented study aimed to explore referral patterns of National Health Service (NHS) Direct to determine how patients engage with telephone-based healthcare and how telephone-based healthcare can manage urgent and emergency care. SETTING NHS Direct, England, UK PARTICIPANTS: NHS Direct anonymised call data (N=1,415,472) were extracted over a representative 1-year period, during the combined month periods of July 2010, October 2010, January 2011 and April 2011. Urgent and emergency calls (N=269,558; 19.0%) were analysed by call factors and patient characteristics alongside symptom classification. Categorical data were analysed using the χ(2) test of independence with cross-tabulations used to test within-group differences. PRIMARY AND SECONDARY OUTCOME MEASURES Urgent and emergency referrals to 999; accident and emergency or to see a general practitioner urgently, which are expressed as call rate per 100 persons per annum. Outcomes related to symptom variations by patient characteristics (age, gender, ethnicity and deprivation) alongside differences by patient characteristics of call factors (date and time of day). RESULTS Urgent and emergency referrals varied by a range of factors relating to call, patient and symptom characteristics. For young children (0-4), symptoms related to 'crying' and 'colds and flu' and 'body temperature change' represented the significantly highest referrals to 'urgent and emergency' health services symptoms relating to 'mental health' alongside 'pain' and 'sensation disorders' represented the highest referrals to urgent and emergency health services for adults aged 40+ years. CONCLUSIONS This study has highlighted characteristics of 'higher likelihood' referrals to urgent and emergency care through the delivery of a national nurse-led telephone healthcare service. This research can help facilitate an understanding of how patients engage with both in and out of hours care and the role of telephone-based healthcare within the care pathway.
منابع مشابه
Use of a service evaluation and lean thinking transformation to redesign an NHS 111 refer to community Pharmacy for Emergency Repeat Medication Supply Service (PERMSS)
OBJECTIVES To demonstrate the contribution of community pharmacy from NHS 111 referrals out of hours (OOH) for emergency supply repeat medication requests via presentation of service activity, community pharmacist feedback and lean thinking transformation. DESIGN Descriptive service evaluation using routine service activity data over the pilot period; survey of community pharmacists, and serv...
متن کاملNHS medical director proposes two tier emergency service.
BMJ | 16 NOVEMBER 2013 | VOLUME 347 1 NHS medical director proposes two tier emergency service Zosia Kmietowicz BMJ The NHS 111 urgent care telephone service increased the use of ambulances in England during its first year of operation—contrary to what it was designed to do—shows an evaluation of pilot sites published in BMJ Open. The Department of Health commissioned the study to evaluate NHS ...
متن کاملImpact of the urgent care telephone service NHS 111 pilot sites: a controlled before and after study
OBJECTIVES To measure the impact of the urgent care telephone service NHS 111 on the emergency and urgent care system. DESIGN Controlled before and after study using routine data. SETTING Four pilot sites and three control sites covering a total population of 3.6 million in England, UK. PARTICIPANTS AND DATA Routine data on 36 months of use of emergency ambulance service calls and inciden...
متن کاملSurgical assessment clinic - One stop emergency out-patient clinic for rapid assessment, reduced admissions and improved acute surgical service: A quality improvement study
Background There is increasing pressure on emergency services within the NHS requiring efficient, rapid assessment and management of patients. A subsequent reduction in hospital admissions reduces overall costs with an aim to improve quality of care. At the Royal Shrewsbury Hospital we run a one stop emergency surgical clinic. With strict criteria for admission to this clinic we have establishe...
متن کاملImpact of route to diagnosis on treatment intent and 1-year survival in patients diagnosed with oesophagogastric cancer in England: a prospective cohort study
OBJECTIVE To investigate the relationship between the route to diagnosis, patient characteristics, treatment intent and 1 -year survival among patients with oesophagogastric (O-G) cancer. SETTING Cohort study in 142 English NHS trusts and 30 cancer networks. PARTICIPANTS Patients diagnosed with O-G cancer between October 2007 and June 2009. DESIGN Prospective cohort study. Route to diagno...
متن کامل