Characteristics and triage in elderly calling a semi-acute medical helpline in Denmark: A prospective cohort study

Objectives To investigate baseline characteristics associated with elderly calling the medical helpline Medical Helpline 1813 (MH1813) in Denmark and how these baseline characteristics were associated with triage outcomes in a subset population of patients with high degree of worry (DOW). Setting: In the Capital Region of Denmark people with acute, non-life-threatening illnesses or injuries are triaged through a single-tier MH1813 for acute healthcare services. Participants: Participants were gathered from a prospective cohort established between 24 January and 9 February 2017 who called the MH1813. Out of 11,413 citizens, 1525 (13.3%) were elderly (≥ 65 years). Callers' identification, age, sex, and contact with general practitioner (GP) prior to MH1813-call were collected from the medical helpline's electronic records. Data were enriched using the callers' self-rated health, self-evaluated degree of worry, and registry data on comorbidities. Results Forty-two percent of call issues were terminated without any further action. Among 882 triaged to a hospital face-to-face consultation, n = 315 (36%) were admitted and 2/3 discharged directly from the emergency department. More than one third of the most worried elderly callers have had a contact with their GP prior to the MH1813 call. A high versus low level of Charlson Comorbidity Index tended to increase admission rate. Seven-hundred-forty-nine (49%) were self-callers and high DOW (crude and adjusted) was significantly associated to a higher triage outcome of admission in both the total population and the patient self-caller population. Adjusted self-rated health was not significantly associated with admission within the subset group of elderly self-callers with DOW 4–5 (n = 364). Men did more often than woman attend a face-to-face consultation (46% vs. 37%) and subsequent admission (23% vs. 18%). Conclusion This study suggests that the aggravation of acute-chronic illnesses among older citizens may lead to acute hospitalization, and inadvertently perpetuating the risk of re-transitions of elderly in the healthcare system.