UNSW study finds helpline directs patients to the right health care

In the largest project of its kind, UNSW big data researchers have analysed 1.2 million calls to a telephone helpline in NSW and found more than two-thirds of callers attended an emergency department when advised to do so.

The research commissioned by Healthdirect Australia and conducted by UNSW Sydney’s Centre for Big Data Research in Health, examined compliance rates with telephone helpline advice, and was published online by Health Research & Education Trust’s (HRET) flagship publication Health Services Research.

Entitled “Emergency Department attendance after telephone triage: a population-based data linkage study”, it is the largest research project of its kind in the world, and one of only a few that links call data to other health services for a whole population.

The research linked the data of 1.2 million calls to the healthdirect helpline (procured and managed by Healthdirect Australia) with routinely collected data about subsequent service use and outcomes.

By linking these record sets, the research provides more reliable and generalised findings than those focused on a subgroup of the population, such as hospital patients.

The project used de-identified data from all calls to the Healthdirect helpline in New South Wales from 2009-2012, linked to records of emergency department presentations, hospital admissions and death registrations.

The research found 66.5% of patients attended an emergency department after being advised to do so, and these patients needed care more urgently compared to the general population of emergency department patients.

General Manager of Clinical Governance at Healthdirect Australia, Maureen Robinson, said the research findings confirmed the importance of telephone helplines as a key part of the Australian health system, ensuring callers make an informed decision about whether to attend ED or not.

“These results clearly show the important part telephone health advice lines play in the care of Australians. By contacting a telephone helpline like Healthdirect in the first instance, people are ensuring any subsequent visit to the ED is necessary.

“This frees up EDs for genuine cases of care. Many callers realise that their health concern does not require a visit to ED and this research validates that. In cases where callers were advised to attend ED, the data shows they were more likely to need to be treated within 30 minutes upon arrival than other ED patients,” Ms Robinson said.

Research Fellow at the Centre for Big Data Research in Health and lead author of the paper Dr Amy Gibson said the decision to seek emergency care is influenced by many different factors, not all within the patient’s control.

“Patients least likely to comply with advice to attend ED were aged between 18 and 44 years, lived in more remote areas of NSW, and had made more calls to the helpline in the previous six months,” Dr Gibson said.

“Patients who had the original intention of attending ED were more likely to comply with advice to do the same, and when they comply, they tend to do so quickly.

“Self-referral to the ED is when a patient attends the ED, despite having been advised to seek no or low urgency care.

“Symptoms can change, as can the urgency of care a patient needs, but we saw higher levels of self-referral in males, adult patients, calls made after hours, in patients with the original intention to seek ED care, and in calls relating to cardiac, hypertension and respiratory symptom,” she said.