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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Kathleen M O'Rourke, PhD, MPH, Biometry and Epidemiology, Medical University of South Carolina, 135 Rutledge Ave, Suite 1134, Charleston, SC 29425, 843-876-1118, orourkek@musc.edu and Mary E. Roddy, PhD, School of Public Health, UT Houston SPH, 1101 Stanton, Suite 110, El Paso, TX 79902.
With military treatment facilities facing capitated budgets under managed care systems, hospital commanders need methods of providing quality care at reduced cost. One option is a nursing triage line, in which nurses evaluate patient's primary symptoms and direct them to the most appropriate level of care. This study evaluated the medical and financial impact of this line on ER and clinic use at a military hospital. There were 22,458 calls to the line from 10/2000 to 9/2001, with the most common dispositions for clinic appointments (41.8%), self-care advice (25.7%), and ER (13.6%). Two analyses compared a subset of patients triaged to specific medical services with patients who made their own appointments, one for the Emergency Room (n=461) and the other for outpatient clinics (n=525). Using logistic regression, controlling for baseline factors, the triage line had no significant impact on the appropriateness of ER usage, with an Odds Ratio (OR) of 1.2, and 95% Confidence Interval (CI) 0.8-1.8. In contrast, clinic appointments made by triage nurses were significantly more timely and appropriate, with ORs of 2.5 (95%CI 1.5-4.2) and 2.8 (95% CI 1.4, 5.3), respectively. Cost-benefit analysis compared the triage disposition with the caller's original intended use of health services, accounting for the cost of these services and the triage line. The triage line resulted in an annual savings of $318,123. This study supports the importance of triage lines as a cost-effective means of identifying health conditions and referring patients to appropriate medical services.
Learning Objectives:
Keywords: Access and Services, Evaluation
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: none
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.