Follow-up After Telephone Consultations at Out-of-Hours Primary Care

Article Figures & Data

Table 1. Patient and Primary Care Physician (PCP) Cooperative Characteristics

Characteristics
Patients (n = 5678)^*
Male sex	2349 (41.4)
Age, years
0–17	941 (16.6)
18–44	1642 (28.9)
45–64	1418 (25.0)
≥65	1677 (29.5)
Type of contact
Telephone consultation	1764 (31.1)
Center consultation	2303 (40.6)
Home visit	1611 (28.4)
Cooperatives (n = 16)^{^†}
Inhabitants (n)	281,882 (110,000–633,000)
PCP density (inhabitants/PCP)	2215 (1805–2683)
Distribution of contact type (%)
Telephone consultation	40.8 (32.0–48.0)
Center consultation	48.7 (41.5–57.0)
Home visit	10.3 (6.0–15.0)
Distance to emergency department (km)	4.7 (0–22)
Triage nurse certification (%)	66.3 (0–100)
Use of computerized decision support system (%)	26.1 (0–100)
Telephone PCP present at call center (%)	56.2 (0–100)

Table 2. Patient Experiences and Follow-up Contact Per Type of Contact (n = 5678)

	Type of Contact
	Telephone consultation (n = 1764)	Center consultation (n = 2303)	Home visit (n = 1611)	Total (n = 5678)
Telephone nurse^*	3.66	3.73	3.71	3.70
Accessibility (% within standard)	80.8	84.3	86.6	83.9
Follow-up contact after contact with PCP cooperative (%)
Own PCP/PCP cooperative	37.1	31.5	40.5	35.8
Emergency department	6.9	8.9	16.8	10.5
Ambulance care	0.7	0.2	1.3	0.7
Total	44.7	40.6	58.6	47.0

↵* Mean of 7 items, with scores ranging from 1 to 4. Mean score was included for patients with ≥5 valid answers.
PCP, primary care physician.

Table 3. Bivariate Analysis of Determinants of a Follow-up Contact

Determinants	Odds Ratio	95% Confidence Interval
Patient characteristics and experiences
Age, years
0–17 (reference)	1.00
18–44	1.43^*	1.20–1.69
45–64	2.13^*	1.80–2.53
≥65	2.88^*	2.44–3.41
Female sex	1.06	0.95–1.17
Accessibility	0.92	0.80–1.06
Experience with telephone nurse (range 1–4)	0.70^*	0.63–0.78
Type of contact
Telephone consultation (reference)
Consultation at center	0.84	0.74–0.95
Home visit	1.74	1.51–1.99
PCP cooperative characteristics
Satellite post	0.81^*	0.71–0.93
Computerized decision support system	0.84	0.69–1.01
Frequency of telephone consultations (%)	1.02^*	1.01–1.03
PCP at the call center	1.01	0.94–1.09
Certified triage nurses (%)	1.00	1.00–1.00
Distance to emergency department (km)	1.01	1.00–1.02

Table 4. Multivariate Analysis of Determinants of a Follow-up Contact (Experiences Triage; n = 5678)

Determinants	Model 1 (Patient Characteristics & Accessibility)		Model 2 (Model 1 + PCP Cooperative Characteristics)
Determinants	Odds Ratio	95% CI	Odds Ratio	95% CI
Patient characteristics and experiences
Age, years
0–17 (reference)	1.00		1.00
18–44	1.32^*	1.11–1.57	1.33^*	1.12–1.58
45–64	1.91^*	1.60–2.28	1.92^*	1.61–2.29
≥65	2.39^*	1.98–2.88	2.39^*	1.99–2.88
Female sex	1.09	0.98–1.22	1.09	0.98–1.22
Accessibility	0.98	0.85–1.14	1.00	0.86–1.16
Experience with telephone nurse	0.68^*	0.61–0.76	0.68^*	0.61–0.76
Type of contact
Telephone (reference)	1.00		1.00
Consultation at center	0.91	0.80–1.04	0.92	0.80–1.04
Home visit	1.33^*	1.14–1.55	1.32^*	1.13–1.54
PCP cooperative characteristics
Satellite post			0.90	0.77–1.04
Frequency of telephone consultations (%)			1.02^*	1.00–1.03