Patient intention and self-reported compliance in relation to emergency department attendance after using an after hours GP helpline

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To determine ED attendance and compliance with GP advice following a call to an after hours telephone triage and advice service.


A descriptive study of users’ of an after hours helpline self-reported ED attendance and compliance with GP recommendation, based on routinely collected service data and telephone survey results for 2783 callers in 2011–2012. The outcome measure was self-reported health service utilisation following advice from a GP on an after hours helpline.


One-third of the sample – 934 callers – intended to visit the ED. Of these, 504 (54%, 95% CI 50.7%–57.2%) reported taking other less urgent options. The GP assessment confirmed the original intention for 224 callers (24%, 95% CI 21.2%–26.9%). However, 151 patients (16%, 95% CI 13.8%–18.6%) did attend the ED as they had originally intended despite the GP's recommendation to seek less serious care, whereas a further 55 patients (6%, 95% CI 4.4%–7.6%) assessed by the GP as requiring ED care chose a less serious option. Fifty-five per cent of all callers who attended ED did not intend to visit the ED prior to their call. The overall net result was a small reduction in ED attendance compared with original intentions.


An after hours GP helpline may divert some callers intending to go to the ED to other care. However, patient non-compliance may limit the capacity of telephone triage and advice service to reduce demand for ED. Further research is needed to better understand the effect of the service.

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