Prior use of a telephone-nursing triage service by patients of emergency services

Objectives: A province-wide telephone-nursing triage service was implemented in Quebec, Canada, in order, among other objectives, to decrease overcrowding in hospital emergency rooms. This study analyses prior use of Info-Sante CLSC telephone service by patients of emergency services. Methods: Structured interviews were conducted with 850 patients of a general hospital emergency room and of walk-in medical clinics. Patients were recruited while waiting to see the physician between 8h and 23h, 7 days a week, from November 1997 to June 1998. Information was collected on knowledge and use of the telephone-nursing triage service, health problem and perceived health status, information-seeking behaviour on health services, utilisation habits, social support, and sociodemographic characteristics. Interval estimates and multiple logistic regressions were performed. Results: Of the patients who were aware of this service, 17,4% (CI95=0, 14-0,20) had used it prior to their medical visit. Among these, 85,1% had received a recommendation to consult a doctor. Among the users who were at the hospital emergency room at the time of the study, 56,4% were advised to consult a walk-in clinic or a CLSC, 28,2% their family doctor and only 12,8% a hospital emergency room. The probability of prior recourse to the telephone nursing service is influenced significantly by the duration of the health problem (2-4 days versus <2 days:. ORadjusted=2,03), new health problem (ORadjusted=1,98) and by the frequenting of walk-in clinics rather than hospital emergency rooms (ORadjusted=0,31). Conclusion : Despite a heightened awareness of the telephone-nursing triage service, few users of emergency services make use of it and, when they do, follow rather loosely the recommendation towards the type of service judged appropriate for their needs.