Reasons for encounter by different levels of urgency in out-of-hours emergency primary health care in Norway: a cross sectional study

Raknes, Guttorm; Hunskaar, Steinar

doi:10.1186/s12873-017-0129-2

Cited by 16 publications

(10 citation statements)

References 8 publications

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“…Na Noruega analisaram as razões de entrada nos serviços de atenção primária fora de hora de emergência e, segundo a triagem, os diagnósticos apresentados foram dores abdominais as mais comuns com nível de urgência na cor amarela e as dores torácicas dominaram as classificações de cores vermelhas, dados esses que parecidos com as hipóteses apresentadas 23 .…”

Section: Discussionunclassified

Sistema de gestão para um hospital de referência

et al. 2019

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Objetivo: conhecer o perfil e demanda de urgência e emergência encaminhadas ao serviço de alta complexidade antes e após a implantação de um sistema de regulação. Metodologia: estudo retrospectivo avaliado por análise estatística de relatórios administrativos do Hospital de Clinicas de Botucatu, considerados dois períodos entre 2015 e 2018, após aprovação pelo Comitê de Ética em Pesquisa, sendo N=8921 antes e N= 10450 após implantação de sistema de regulação. Resultados: observa-se prevalência da população residente do município de Botucatu, sexo masculino com média de idade 40 anos, com entrada no serviço devido fratura, trauma, afecções cardíacas e acidente vascular cerebral com tempo médio de regulação de 1 hora, 43 minutos e 48 segundos. Conclusão: encaminhamentos classificados como urgência mínima representaram 55,1% das solicitações, 12,5% dos encaminhamentos foram contrarreferenciados. O conhecimento do fluxo e demanda contribui para a regulação do paciente.

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Section: Discussionunclassified

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“…The average number of inhabitants corresponded to approximately 4.6% of the total Norwegian population during the study period. The Watchtower project is funded by the National Centre for Emergency Primary Health Care, and further project details are described thoroughly elsewhere [29,30].…”

Section: Design and Settingmentioning

confidence: 99%

“…We consider 9% missing ICPC-2 codes as a low percentage. One possible reason for lacking data might be difficulties in deciding the RFE among older people, but a previous study that analysed the same material found that there were no age differences in lacking ICPC-2 codes [30]. We used both adjusted and unadjusted models in the log binomial regression analyses in order to take into account the effects of other factors that may have been missed in an unadjusted model alone.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Contact characteristics and factors associated with the degree of urgency among older people in emergency primary health care: a cross-sectional study

Haraldseide

Sortland

Hunskaar

et al. 2020

BMC Health Serv Res

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Background: As the proportion of older people increases, so will the consumption of health services. The aim of this study was to describe the contact characteristics among older people and to identify factors associated with the degree of urgency at the Norwegian out-of-hours (OOH) emergency primary health care services. Methods: Inhabitants aged ≥70 years who contacted the OOH service during 2014-2017 in seven OOH districts in Norway were included. We investigated the variables sex, age, time of contact, mode of contact, ICPC-2 based reason for encounter (RFE), priority degree and initial response. We also performed frequency analyses, rate calculations and a log-binomial regression. Results: A total of 38,293 contacts were registered. The contact rate/1000 inhabitants/year was three times higher in the oldest age group (≥90 years) compared to the youngest age group (70-74 years). Direct attendance accounted for 8.4% of the contacts and 32.8% were telephone contacts from health professionals. The most frequent RFE chapter used was "A General and unspecified" (21.0%) which also showed an increasing rate with higher age. 6.0% of the contacts resulted in a home visit from a doctor. Variables significantly associated with urgent priority degree were RFEs regarding cardiovascular (Relative risk (

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“…There is a lack of epidemiological studies documenting which medical problems and reason for encounter (RFE) are resolved and handled by nurses’ telephone advice in the OOH services. Some European studies include information on the RFE using the ICPC-2 classification system [ 29 – 32 ]. In a Dutch study, researchers explored nurse telephone triage using the determinants of independent advice and return consultation [ 33 ].…”

Section: Introductionmentioning

confidence: 99%

Telephone counselling by nurses in Norwegian primary care out-of-hours services: a cross-sectional study

2017

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BackgroundThe primary care out-of-hours (OOH) services in Norway are characterized by high contact rates by telephone. The telephone contacts are handled by local emergency medical communication centres (LEMCs), mainly staffed by registered nurses. When assessment by a medical doctor is not required, the nurse often handles the contact solely by nurse telephone counselling. Little is known about this group of contacts. Thus, the aim of this study was to investigate characteristics of encounters with the OOH services that are handled solely by nurse telephone counselling.MethodsNurses recorded ICPC-2 reason for encounter (RFE) codes and patient characteristics of all patients who contacted six primary care OOH services in Norway during 2014. Descriptive statistics and frequency analyses were applied.ResultsOf all telephone contacts (n = 61,441), 23% were handled solely by nurse counselling. Fever was the RFE most frequently handled (7.3% of all nurse advice), followed by abdominal pain, cough, ear pain and general symptoms. Among the youngest patients, 32% of the total telephone contacts were resolved by nurse advice compared with 17% in the oldest age group. At night, 31% of the total telephone contacts were resolved solely by nurse advice compared with 21% during the day shift and 23% in the evening. The share of nurse advice was higher on weekdays compared to weekends (mean share 25% versus 20% respectively).ConclusionThis study shows that nurses make a significant contribution to patient management in the Norwegian OOH services. The findings indicate which conditions nurses should be able to handle by telephone, which has implications for training and routines in the LEMCs. There is the potential for more nurse involvement in several of the RFEs with a currently low share of nurse counselling.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-017-0651-z) contains supplementary material, which is available to authorized users.

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Reasons for encounter by different levels of urgency in out-of-hours emergency primary health care in Norway: a cross sectional study

Cited by 16 publications

References 8 publications

Sistema de gestão para um hospital de referência

Sistema de gestão para um hospital de referência

Contact characteristics and factors associated with the degree of urgency among older people in emergency primary health care: a cross-sectional study

Telephone counselling by nurses in Norwegian primary care out-of-hours services: a cross-sectional study

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