Abstract:
OBJECTIVE:To investigate the appropriateness of cases presenting to the emergency department (ED) following ambulance-based secondary telephone triage. DESIGN:A pragmatic retrospective cohort analysis of all the planned and unplanned ED presentations within 48 hours of a secondary telephone triage. SETTING:The secondary telephone triage service, called the Referral Service, and the hospitals were located in metropolitan Melbourne, Australia and operated 24 hours a day, servicing 4.25 million people. The Referral Service provides an in-depth secondary triage of cases classified as low acuity when calling the Australian emergency telephone number. POPULATION:Cases triaged by the Referral Service between September 2009 and June 2012 were linked to ED and hospital admission records (N=44,523). Planned ED presentations were cases referred to the ED following the secondary triage, unplanned ED presentations were cases that presented despite being referred to alternative care pathways. MAIN OUTCOME MEASURES:Appropriateness was measured using an ED suitability definition and hospital admission rates. These were compared with mean population data which consisted of all of the ED presentations for the state (termed the 'average Victorian ED presentation'). RESULTS:Planned ED presentations were more likely to be ED suitable than unplanned ED presentations (OR 1.62; 95% CI 1.5 to 1.7; p<0.001) and the average Victorian ED presentation (OR 1.85; 95% CI 1.01 to 3.4; p=0.046). They were also more likely to be admitted to the hospital than the unplanned ED presentation (OR 1.5; 95% CI 1.4 to 1.6; p<0.001) and the average Victorian ED presentation (OR 2.3, 95% CI 2.24 to 2.33; p<0.001). Just under 15% of cases diverted away from the emergency care pathways presented in the ED (unplanned ED attendances), and 9.5% of all the alternative care pathway cases were classified as ED suitable and 6.5% were admitted to hospital. CONCLUSIONS:Secondary telephone triage was able to appropriately identify many ED suitable cases, and while most cases referred to alternative care pathways did not present in the ED. Further research is required to establish that these were not inappropriately triaged away from the emergency care pathways.
journal_name
BMJ Openjournal_title
BMJ openauthors
Eastwood K,Smith K,Morgans A,Stoelwinder Jdoi
10.1136/bmjopen-2017-016845subject
Has Abstractpub_date
2017-10-15 00:00:00pages
e016845issue
10issn
2044-6055pii
bmjopen-2017-016845journal_volume
7pub_type
杂志文章相关文献
BMJ Open文献大全abstract:OBJECTIVES:The aim of this study was to develop a single blood test that could determine gestational age and estimate the risk of preterm birth by measuring serum metabolites. We hypothesised that serial metabolic modelling of serum analytes throughout pregnancy could be used to describe fetal gestational age and proje...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-040647
更新日期:2020-12-02 00:00:00
abstract:OBJECTIVES:To gather knowledge on the current debate, opinions and attitudes of Italian patient and citizen groups on individual participant data (IPD) sharing from clinical studies. DESIGN:Cross-sectional online survey. SETTING AND PARTICIPANTS:A 22-item online questionnaire was sent by email to 2003 contacts of pat...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-024863
更新日期:2019-02-19 00:00:00
abstract:OBJECTIVE:To assess changes in incidence, diagnostic procedures, comorbidity profiles, length of hospital stay (LOHS), economic costs and in-hospital mortality (IHM) associated with idiopathic pulmonary fibrosis (IPF). METHODS:We identified patients hospitalised with IPF in Spain from 2004 to 2013. Data were collected...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-013156
更新日期:2017-02-13 00:00:00
abstract:OBJECTIVES:Undertake a systematic scoping review to determine how a research evidence base, in the form of existing systematic reviews in the field of mobile health (mHealth), constitutes education and training for community health workers (CHWs) who use mobile technologies in everyday work. The review was informed by ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-019827
更新日期:2018-07-30 00:00:00
abstract:OBJECTIVES:Malignant melanoma has high morbidity and mortality rates. Early diagnosis improves prognosis. Clinical prediction rules (CPRs) can be used to stratify patients with symptoms of suspected malignant melanoma to improve early diagnosis. We conducted a systematic review of CPRs for melanoma diagnosis in ambulat...
journal_title:BMJ open
pub_type: 杂志文章,评审
doi:10.1136/bmjopen-2016-014096
更新日期:2017-03-06 00:00:00
abstract:OBJECTIVES:The field of sport injury prevention has seen a marked increase in published research in recent years, with concomitant proliferation of lay sport safety resources, such as policies, fact sheets and posters. The aim of this study was to catalogue and categorise the number, type and topic focus of sport safet...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-010877
更新日期:2016-05-06 00:00:00
abstract:OBJECTIVES:Acute respiratory infections (ARIs) are a global cause of childhood morbidity. We compared temporal trends and socioeconomic disparities for ARI hospitalisations in young children across Western Australia, England and Scotland. DESIGN:Retrospective population-based cohort studies using linked birth, death a...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-028710
更新日期:2019-05-19 00:00:00
abstract:INTRODUCTION:People living with and beyond cancer are vulnerable to a number of physical, functional and psychological issues. Undertaking a holistic needs assessment (HNA) is one way to support a structured discussion of patients' needs within a clinical consultation. However, there is little evidence on how HNA impac...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2014-006840
更新日期:2015-05-11 00:00:00
abstract:INTRODUCTION:An acute exacerbation of chronic obstructive pulmonary disease (COPD) marks a critical life event, which can lower patient quality of life and ability to perform daily activities. Patients with COPD tend to lead inactive and highly sedentary lifestyles, which may contribute to reductions in functional capa...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2016-013014
更新日期:2016-10-03 00:00:00
abstract:OBJECTIVE:Canada is among the few countries in which e-cigarettes containing nicotine are prohibited. To date, there is little evidence on the prevalence and patterns of use of e-cigarettes in markets with product bans. The current study examines e-cigarette use among a sample of non-smokers and smokers in Canada. DES...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-007971
更新日期:2015-08-26 00:00:00
abstract:OBJECTIVES:The study analysed medical malpractice claims to assess patient safety in hospitals. The information derived from malpractice claims reflects potential risks and could help lead to reducing medical errors and improving patient safety. DESIGN, SETTING:We analysed 4380 medical malpractice claims from 351 grad...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-034681
更新日期:2020-09-24 00:00:00
abstract:OBJECTIVE:Both environmental and genetic factors play important roles in the development of metabolic syndrome (MetS). Studies about its associated factors and genetic contribution in African Americans (AA) are sparse. Our aim was to report the prevalence, associated factors and heritability estimates of MetS and its c...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-008675
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Female injection drug users (IDUs) may report differences in injection behaviours that put them at greater risk for hepatitis C virus (HCV). Few studies have examined these in association with HCV incidence. METHODS:Longitudinal data from a cohort of 417 HCV-uninfected IDU aged 30 or younger were analysed. ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2014-004988
更新日期:2014-05-29 00:00:00
abstract:OBJECTIVE:The objective of this study is to assess the determinants of BCG vaccination in Ethiopia from 2016 Ethiopia Demographic and Health Survey (EDHS). SETTING:Since Ethiopia has nine regional states and two administrative cities, sample was taken from all the divisions. The population-based sample was intended to...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-023634
更新日期:2019-02-21 00:00:00
abstract:OBJECTIVES:To explore the usefulness of Bioelectrical Impedance Analysis (BIA) for general use by identifying best-evidenced formulae to calculate lean and fat mass, comparing these to historical gold standard data and comparing these results with machine-generated output. In addition, we explored how to best to adjust...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-008922
更新日期:2016-01-07 00:00:00
abstract:INTRODUCTION:In recent years, it has been demonstrated that photobiomodulation therapy (PBMT) using low-level laser therapy and/or light-emitting diode therapy combined to static magnetic field (sMF) has ergogenic effects, improving muscular performance and accelerating postexercise recovery. However, many aspects rela...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2019-030194
更新日期:2019-10-28 00:00:00
abstract:OBJECTIVES:First, to examine general practitioner (GP) knowledge about the care (needs) of their patients; second, to examine the quality of GP follow-up care; third, to examine the transmission of patient care information from hospitals/emergency services (ES) to GPs. SETTING:105 general practices from the representa...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-028546
更新日期:2019-05-05 00:00:00
abstract:OBJECTIVE:To explore patients' experience of receiving pain relief injection for suspected hip fracture from paramedics at the location of the injury. DESIGN:Qualitative interviews within a feasibility trial about an alternative to routine prehospital pain management for patients with suspected hip fracture. SETTING:...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-033398
更新日期:2019-12-19 00:00:00
abstract:OBJECTIVES:To identify ways of using routine hospital data to improve the efficiency of retrospective reviews of case records for identifying avoidable severe harm DESIGN: Development and testing of thresholds and criteria for two indirect indicators of healthcare-related harm (long length of stay (LOS) and emergency r...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-025372
更新日期:2019-06-21 00:00:00
abstract:OBJECTIVE:Illness perception has been shown to have significant influence on the well-being and coping strategies of persons living with chronic medical conditions. Understanding of how women living with breast cancer cognitively and emotionally represent their illness and coping strategies used is likely to help in de...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-033019
更新日期:2020-07-14 00:00:00
abstract:OBJECTIVE:To examine the change in both the prevalence and severity of metabolic syndrome (MetS) in the Sami and non-Sami in Northern Norway due to a lack of knowledge regarding the development of MetS in this population. DESIGN:Repeated cross-sectional study. SETTING:The study is based on data from the SAMINOR 1 Sur...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2018-027791
更新日期:2019-06-14 00:00:00
abstract:OBJECTIVES:To compare cardiovascular fitness and physical activity of schoolchildren 18 months after London 2012 according to Olympic 'inspiration'. DESIGN:A cross-sectional comparison between groups of schoolchildren categorised according to self-reported Olympic inspiration and a repeated cross-sectional comparison ...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2016-011670
更新日期:2016-11-23 00:00:00
abstract:OBJECTIVES:To investigate the association between area deprivation at municipality level with low perceived social support, independent of individual socioeconomic position and demographic characteristics. To assess whether there are gender inequalities in this association. DESIGN:Cross-sectional multilevel analysis o...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-019973
更新日期:2018-04-12 00:00:00
abstract:INTRODUCTION:Persistent infection with sexually transmitted, high-risk human papillomavirus (HPV) types is the cause of all cervical cancers and some anogenital and oropharyngeal cancers. HPV is an extremely common asymptomatic infection but little known and poorly understood by the public. Patients with HPV-related ca...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-011205
更新日期:2016-04-25 00:00:00
abstract:OBJECTIVES:The aim of the study was to assess whether gastrostomy placement before 18 months of age results in a greater increase in z-score for weight and to assess whether admission rates were reduced postgastrostomy in this age group. DESIGN:Retrospective cross-sectional study. SETTING:Single-centre secondary care...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-001793
更新日期:2012-11-21 00:00:00
abstract:OBJECTIVES:People interact with their work environment through being, to a greater or lesser extent, compatible with aspects of their setting. This interaction between person and environment is particularly relevant in healthcare settings where compatibility affects not only the healthcare professionals, but also poten...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-026266
更新日期:2019-05-09 00:00:00
abstract:OBJECTIVES:To evaluate the impact of a patient-specific national programme targeting older Australians and health professionals that aimed to increase use of emollient moisturisers to reduce to the risk of skin tears. DESIGN:A prospective cohort intervention. PARTICIPANTS:The intervention targeted 52 778 Australian G...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-039579
更新日期:2020-10-29 00:00:00
abstract:OBJECTIVE:Despite tremendous efforts to scale up key maternal and child health interventions in Zambia, progress has not been uniform across the country. This raises fundamental health system performance questions that require further investigation. Our study investigates technical and scale efficiency (SE) in the deli...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-012321
更新日期:2017-01-05 00:00:00
abstract:INTRODUCTION:Cancer is one of the leading causes of death globally and many jurisdictions have developed population-based cancer screening programmes to reduce the public health burden of disease. However, screening participation remains suboptimal. Social media and other mobile health (mHealth) technologies are increa...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-035411
更新日期:2020-02-05 00:00:00
abstract:INTRODUCTION:Worldwide, 10%-20% of children and adolescents experience mental health conditions. However, most such disorders remain undiagnosed until adolescence or adulthood. Little is known about the factors that influence mental health in children and adolescents, especially in low and middle-income countries (LMIC...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-029332
更新日期:2019-10-16 00:00:00