Medical telephone triage and patient behaviour: How do they compare?

Questions Under Study: In the medical call centre Medi-24, medical experts advise people with health problems on the optimal treatment. The purpose of the first part of this study was to answer two questions: To what extend do callers and medical experts differ in their judgement of a health problem, and to what degree are patients compliant to experts' advice.

Methods: 834 callers were selected for study inclusion. At the call centre, study participants were asked about their intended behaviour prior to the call and approximately 90% of these were interviewed one week later about their subsequent behaviour following the call. The standardised data were analysed fitting a logistic regression model.

Results: 61% of callers had not intended to behave the way they were subsequently advised to do. The compliance rate after the triage call was 56%. Non-compliance was largely due to the caller's recollection errors or to a change in the perceived intensity of the health problem. Advice on self-care resulted in an above average compliance. A high compliance was also found when the advice on emergency treatment coincided with the patient's own intended emergency treatment.

Conclusion: The high compliance for the self-care advice showed that patients could be persuaded by the Medi-24 service that professional health care was not necessary. It appeared more difficult to persuade those patients to make an emergency consultation who had initially not intended to do so.