An assessment of pediatric after-hours telephone care: a 1-year experience.

Background: Pediatric after-hours telephone triage by call center nurses is an important part of pediatric health care provision.

Objectives: To use a computerized database including the after-hours telephone calls for 90% of the pediatricians in Colorado to examine: (1) the epidemiology of after-hours calls during a 1-year period including the volume, seasonality, and timing of after-hours calls, the age of the patients, the presenting complaint, the triage dispositions, and mean rates of calls per pediatrician; (2) the process of care measures at the call center, including waiting times for nurse telephone call-backs, the length of triage calls, and how these factors varied by season; and (3) the frequency and content of calls requesting information but not requiring triage.

Design: Descriptive study.

Changes in access, utilization, and quality of care after enrollment into a state child health insurance plan.

Background: There currently are few published data evaluating the effect of State Children's Health Insurance Programs on health care outcome measures in children. Colorado's Child Health Plan Plus (CHP+) is a non-Medicaid State Children's Health Insurance Program that began enrollment in April 1998. The objectives of this study were to compare reported (1) access to care, (2) utilization of health care, and (3) quality of care during the year before and the first year after enrollment into CHP+.

Disenrollment from a state child health insurance plan: are families jumping S(c)HIP?

Background: Colorado's Child Health Plan Plus (CHP+) is a non-Medicaid state child health plan that began enrollment in April 1998. Families are disenrolled 12 months after enrollment if they fail to re-enroll.

Objective: To assess insurance coverage before and 1 year after initial enrollment in CHP+; reasons for disenrollment; and factors associated with re-enrollment.

Outcomes associated with pediatric after-hours care by call centers: a multicenter study.

Objectives: To assess 1) parental opinion regarding appropriateness of triage, 2) utilization outcomes, and 3) the frequency of underreferral with subsequent hospitalization for children triaged by nurses at pediatric call centers.

Design/methods: From August 19 to October 1999, after-hours calls were randomly sampled from computerized records at 4 call centers at children's hospitals. Telephone surveys were conducted 3 to 7 days after the index calls.

Consistency of triage decisions by call center nurses.

Objectives: To 1) assess consistency in triage disposition among pediatric telephone triage nurses using computer-based algorithms and 2) determine agreement between nurse dispositions and protocol dispositions.

Design/methods: Fifteen nurses from the After Hours Telephone Care Program in Denver were randomly selected to receive mock calls from standardized patients. Each nurse received the same 15 scenarios.