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Evidence summaries

Telephone Consultation and Triage: Effects on Health Care Use and Patient Satisfaction

Telephone consultation may reduce the number of surgery contacts and out-of-hours visits by general practitioners but the overall effect on service use, safety, cost and patient satisfaction remains unclear. Level of evidence: "C"

A Cochrane review [Abstract] 1 included nine studies on the effects of telephone consultation on safety, service usage and patient satisfaction (five RCTs, one CCT and three interrupted time series). Six studies compared telephone consultation versus normal care; four by a doctor, one by a nurse and one by a clinic clerk. Three studies compared telephone consultation by different types of health care workers; two compared nurses with doctors and one compared health assistants with doctors or nurses. Three of five studies found a decrease in visits to GP's but two found a significant increase in return consultations. In general at least 50% of calls were handled by telephone advice alone. Seven studies looked at accident and emergency department visits, six showed no difference between the groups and one, of nurse telephone consultation, found an increase in visits. Two studies reported deaths and found no difference between nurse telephone triage and normal care.

Comment: The quality of evidence is downgraded by limitations in study quality and by inconsistency (heterogeneity in interventions and outcomes).

    References

    • Bunn F, Byrne G, Kendall S. Telephone consultation and triage: effects on health care use and patient satisfaction. Cochrane Database Syst Rev 2004;(3):CD004180 [Last assessed as up-to-date: 14 February 2008]. [PubMed]

Primary/Secondary Keywords