Objective 

Telephone triage service in emergency care has been introduced in many countries, and it is important to determine the effect of telephone triage service on the outcome of emergency patients. The aim of this study was to evaluate the effect of telephone triage service on the outcome of emergency patients using propensity score.

Methods design, settings, and participants 

This was a retrospective study with a study period from January 2016 to December 2019. We included all patients transported by ambulances of the Osaka Municipal Fire Department during study period.

Exposure 

Telephone triage service.

Outcome measures and analysis 

The main outcome of this study was unfavorable outcome following use of the telephone triage service. In this study, unfavorable outcome was defined as patients who were admitted, transferred, or died after care in the emergency department. Propensity scores were calculated using a logistic regression model with 12 variables that were present before the telephone triage service was used or were indicative of the patient’s condition. Data analyses were not only propensity score matching but also a multivariable logistic regression model and regression model with propensity score as a covariate.

Main results 

The number of patients eligible for analyses was 707 474. Of these patients, 8008 (1.0%) used the telephone triage services and 699 466 patients (99.0%) did not use it. The number of patients with an unfavorable outcome was 407 568 (57.6%) in the total cohort. Of them, 2305 patients (28.8%) used the telephone triage service and 297 601 patients (42.5%) did not use it. For propensity score matching, 8008 patients were matched from each group. Use of the telephone triage service was inversely associated with unfavorable outcome in a multivariate logistic regression model with propensity score as a covariate [adjusted odds ratio (OR) 0.874; 95% confidence interval (CI), 0.831–0.919] and propensity score matching (crude OR, 0.875; 95% CI, 0.818–0.936).

Conclusions 

This study revealed that the use of the telephone triage service in Osaka city, Japan was associated with better outcomes of patients transported by ambulance.

中文翻译：

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电话分诊服务为急诊患者带来更好的结果：日本大阪市的一项基于人群的研究

客观的 

许多国家已在急诊护理中引入电话分诊服务，确定电话分诊服务对急诊患者转归的影响非常重要。本研究的目的是利用倾向评分来评估电话分诊服务对急诊患者预后的影响。

方法设计、设置和参与者 

这是一项回顾性研究，研究期间为2016年1月至2019年12月。我们纳入了研究期间大阪市消防局救护车运送的所有患者。

接触 

电话分诊服务。

结果衡量和分析 

这项研究的主要结果是使用电话分诊服务后的不利结果。在这项研究中，不良结果被定义为在急诊室接受治疗、转院或死亡的患者。使用逻辑回归模型计算倾向得分，该模型包含 12 个变量，这些变量在使用电话分诊服务之前存在或表明患者的状况。数据分析不仅是倾向得分匹配，而且是多变量逻辑回归模型和以倾向得分为协变量的回归模型。

主要结果 

符合分析条件的患者人数为 707 474 名。其中，8008 名患者（1.0%）使用了电话分诊服务，699 466 名患者（99.0%）没有使用电话分诊服务。总队列中出现不良结果的患者人数为 407 568 名（57.6%）。其中，2 305 名患者（28.8%）使用了电话分诊服务，297 601 名患者（42.5%）没有使用电话分诊服务。对于倾向评分匹配，每组匹配了 8008 名患者。在以倾向评分为协变量的多变量逻辑回归模型中，电话分类服务的使用与不良结果呈负相关[调整后的比值比 (OR) 0.874；95% 置信区间 (CI)，0.831–0.919] 和倾向评分匹配（粗 OR，0.875；95% CI，0.818–0.936）。

结论 

这项研究表明，日本大阪市使用电话分诊服务与救护车运送患者的更好结果相关。