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The epidemiology of demand for and outcomes of contacts with telephone based healathcare with particular reference to ward deprivation scores: Analysis of calls to NHS Direct Wales 2002-2004. / Julie Patricia Peconi

Swansea University Author: Julie Patricia Peconi

Abstract

NHS Direct Wales (NHSDW) is a nurse-led 24-hour health advice and information line. This study estimated the effect of deprivation on the demand for, and outcome of, direct calls to NHSDW after controlling for potentially confounding factors.The author analysed anonymous data from NHSDW on 410,000 c...

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Published: 2014
Institution: Swansea University
Degree level: Doctoral
Degree name: Ph.D
URI: https://cronfa.swan.ac.uk/Record/cronfa42858
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last_indexed 2019-10-21T16:48:35Z
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spelling 2018-08-29T15:05:42.1012450 v2 42858 2018-08-02 The epidemiology of demand for and outcomes of contacts with telephone based healathcare with particular reference to ward deprivation scores: Analysis of calls to NHS Direct Wales 2002-2004. 90fa2c5a49d4968298f1cf49823065cb NULL Julie Patricia Peconi Julie Patricia Peconi true true 2018-08-02 NHS Direct Wales (NHSDW) is a nurse-led 24-hour health advice and information line. This study estimated the effect of deprivation on the demand for, and outcome of, direct calls to NHSDW after controlling for potentially confounding factors.The author analysed anonymous data from NHSDW on 410,000 calls over 2.5 years, including patient characteristics (age, gender, relationship to caller, ward of residence) and call characteristics (whether for triage or information, day of call). To each call she added ward data including: the corresponding Welsh Index of Multiple Deprivation score; population density; and distance from nearest Emergency Department (ED). She used multiple linear regression to model the relationship between deprivation and demand and binary logistic regression to model the relationship between deprivation and outcome.Confounding variables explained 33.0% of variation in advice call rates; and 27.5% of that in information call rates (both significant at 0.1% level). Deprivation was not a statistically significant predictor of these rates (significance levels 0.158 and 0.244 respectively). Deprivation had more effect on outcomes: an increase in deprivation from one fifth to the next fifth increased by 13% the probability of receiving advice to call 999 emergency care within triage calls [Odds ratio (OR) 1.127; 95% confidence interval (Cl) from 1.113 to 1.143]; and that of receiving advice to seek care face to face rather than self care by 5% (OR 1.049; Cl from 1.041 to 1.058) for triage calls and by 3% (OR 1.034; Cl from 1.022 to 1.047) for information calls.In short, deprivation had no detectable effect on demand for calls, but a positive effect on the outcome of the call. While it is possible that the data underestimated the ‘need’ of deprived patients for healthcare, they yield no evidence that NHSDW should seek to improve access from those patients E-Thesis NHS Direct Wales, health 31 12 2014 2014-12-31 COLLEGE NANME Swansea University Medical School COLLEGE CODE Swansea University Doctoral Ph.D 2018-08-29T15:05:42.1012450 2018-08-02T16:24:30.6481970 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Julie Patricia Peconi NULL 1 0042858-02082018162527.pdf 10821248.pdf 2018-08-02T16:25:27.4030000 Output 48390795 application/pdf E-Thesis true 2018-08-02T16:25:27.4030000 false
title The epidemiology of demand for and outcomes of contacts with telephone based healathcare with particular reference to ward deprivation scores: Analysis of calls to NHS Direct Wales 2002-2004.
spellingShingle The epidemiology of demand for and outcomes of contacts with telephone based healathcare with particular reference to ward deprivation scores: Analysis of calls to NHS Direct Wales 2002-2004.
Julie Patricia Peconi
title_short The epidemiology of demand for and outcomes of contacts with telephone based healathcare with particular reference to ward deprivation scores: Analysis of calls to NHS Direct Wales 2002-2004.
title_full The epidemiology of demand for and outcomes of contacts with telephone based healathcare with particular reference to ward deprivation scores: Analysis of calls to NHS Direct Wales 2002-2004.
title_fullStr The epidemiology of demand for and outcomes of contacts with telephone based healathcare with particular reference to ward deprivation scores: Analysis of calls to NHS Direct Wales 2002-2004.
title_full_unstemmed The epidemiology of demand for and outcomes of contacts with telephone based healathcare with particular reference to ward deprivation scores: Analysis of calls to NHS Direct Wales 2002-2004.
title_sort The epidemiology of demand for and outcomes of contacts with telephone based healathcare with particular reference to ward deprivation scores: Analysis of calls to NHS Direct Wales 2002-2004.
author_id_str_mv 90fa2c5a49d4968298f1cf49823065cb
author_id_fullname_str_mv 90fa2c5a49d4968298f1cf49823065cb_***_Julie Patricia Peconi
author Julie Patricia Peconi
author2 Julie Patricia Peconi
format E-Thesis
publishDate 2014
institution Swansea University
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description NHS Direct Wales (NHSDW) is a nurse-led 24-hour health advice and information line. This study estimated the effect of deprivation on the demand for, and outcome of, direct calls to NHSDW after controlling for potentially confounding factors.The author analysed anonymous data from NHSDW on 410,000 calls over 2.5 years, including patient characteristics (age, gender, relationship to caller, ward of residence) and call characteristics (whether for triage or information, day of call). To each call she added ward data including: the corresponding Welsh Index of Multiple Deprivation score; population density; and distance from nearest Emergency Department (ED). She used multiple linear regression to model the relationship between deprivation and demand and binary logistic regression to model the relationship between deprivation and outcome.Confounding variables explained 33.0% of variation in advice call rates; and 27.5% of that in information call rates (both significant at 0.1% level). Deprivation was not a statistically significant predictor of these rates (significance levels 0.158 and 0.244 respectively). Deprivation had more effect on outcomes: an increase in deprivation from one fifth to the next fifth increased by 13% the probability of receiving advice to call 999 emergency care within triage calls [Odds ratio (OR) 1.127; 95% confidence interval (Cl) from 1.113 to 1.143]; and that of receiving advice to seek care face to face rather than self care by 5% (OR 1.049; Cl from 1.041 to 1.058) for triage calls and by 3% (OR 1.034; Cl from 1.022 to 1.047) for information calls.In short, deprivation had no detectable effect on demand for calls, but a positive effect on the outcome of the call. While it is possible that the data underestimated the ‘need’ of deprived patients for healthcare, they yield no evidence that NHSDW should seek to improve access from those patients
published_date 2014-12-31T03:53:47Z
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score 11.016235

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