The Reason-for-Encounter mode of the ICPC: Reliable, adequate, and feasible

Horst, Frans van der; Metsemakers, Job; Vissers, Frans; Saenger, Gerhart; Geus, C de

doi:10.3109/02813438909088655

Cited by 12 publications

(10 citation statements)

References 2 publications

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“…However, symptoms are the dominating RFEs in our data material. The RFE mode of the ICPC system has also been found to be a reliable tool for registering RFEs in the primary care sector [ 38 ].…”

Section: Discussionmentioning

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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Section: Discussionmentioning

confidence: 99%

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

2017

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“…Symptoms, signs and general contact reasons dominate, and such RFEs provide a good basis for triage and limit bias in the following diagnostic process. The Reason-for-Encounter mode of the ICPC has proven reliable, adequate, and feasible [14]. …”

Section: Discussionmentioning

confidence: 99%

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

Raknes

Hunskaar

2017

BMC Emerg Med

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BackgroundFrequencies of reasons for encounter (RFEs) in emergency primary care out-of-hours (OOH) services are relevant for planning of capacities as well as to target the training of staff at casualty clinics. We aimed to present frequencies of RFEs in the different organ systems, and to identify the most frequent RFEs at different urgency levels.MethodsWe analyzed data on RFEs in Norwegian OOH services. International Classification of Primary Care (ICPC-2) RFE codes were recorded in all contacts to eight representative OOH casualty clinics in 2014 and 2015 covering 20 municipalities with a total population of 260 196. Frequencies of each ICPC-2 chapters and groups of ICPC-2 codes were calculated at different urgency levels.ResultsMusculoskeletal, respiratory, skin, digestive and general and unspecified issues were the most frequent RFE groups. Fever was the most frequent single ICPC-2 RFE code, but was less common among the most urgent cases. Abdominal pain was the most common RFE in patients with yellow urgency level (urgent), and chest pain dominated the potentially red (potentially life threatening) cases. There was less variation in the use of ICPC-2 with increasing urgency level.ConclusionsThis study identifies important differences in RFEs between urgency levels in the Norwegian OOH services. The findings provide new insight into the function of the primary health care emergency services in the Norwegian health care system, and should have implications for staffing, training and equipment in the OOH services.Electronic supplementary materialThe online version of this article (doi:10.1186/s12873-017-0129-2) contains supplementary material, which is available to authorized users.

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“…The RFE was determined from the patient's main complaint or stated reason for contact. ICPC-2 is accepted as a mode of classifying RFEs in primary health care and has proven to be a reliable tool [31,32].…”

Section: Variablesmentioning

confidence: 99%

“…The most frequent RFEs by ICPC-2 codes and initial response; medical consultation doctor, telephone advice, home visit by doctor, call out by ambulance and doctor (n =32,386) …”

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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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The Reason-for-Encounter mode of the ICPC: Reliable, adequate, and feasible

Cited by 12 publications

References 2 publications

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

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

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

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

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