Published online February 1, 2007
PEDIATRICS Vol. 119 No. 2 February 2007, pp. e305-e313 (doi:10.1542/10.1542/peds.2006-1511)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bunik, M.
Right arrow Articles by Kempe, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bunik, M.
Right arrow Articles by Kempe, A.
Related Collections
Right arrow Office Practice
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

ARTICLE

Pediatric Telephone Call Centers: How Do They Affect Health Care Use and Costs?

Maya Bunik, MD, MSPHa,b, Judith E. Glazner, MSc, Vijayalaxmi Chandramouli, MSd, Caroline Bublitz Emsermann, MSe, Teresa Hegarty, RNb and Allison Kempe, MD, MPHa,b,c

a Departments of Pediatrics
c Preventive Medicine and Biometrics
e Family Medicine
d Colorado Health Outcomes Program, University of Colorado at Denver and Health Sciences Center, Denver, Colorado
b Children's Outcomes Research Program, Children's Hospital, Denver, Colorado

OBJECTIVES. After-hours call centers have been shown to provide appropriate triage with high levels of parental and provider satisfaction. However, few data are available on the costs and outcomes of call centers from the perspective of the health care system. With this study we sought to determine these outcomes.

METHODS. Parents who called the Pediatric After-hours Call Center at the Children's Hospital of Denver from March 19, 2004, to April 19, 2004, were asked an open-ended question before triage: "We would like to know, what you would have done if you could not have called our call center this evening/today?"

RESULTS. The response rate for the survey was 77.8% (N = 8980). Parents reported that they would have (1) gone to an emergency department or urgent care facility (46%), (2) treated the child at home (21%), (3) called a physician's office the next day (12%), (4) asked another person for advice (13%), (5) consulted a written source (2%), or (6) other (7%). Of the 46% of callers who would have sought emergent care, only 13.5% subsequently were given an urgent disposition by the call center. Fifteen percent of cases in which the parents would have stayed at home were given an urgent disposition by nurses. Assuming that all callers followed the advice provided, the estimated savings per call, based on local costs, was $42.61 per call. Savings based on Medical Expenditure Panel Survey national payment data were $56.26 per call.

CONCLUSIONS. Two thirds of the cases in which parents reported initial intent to go to an emergency department or urgent care facility were not deemed urgent by the call center, whereas 15% of calls from parents who intended to stay home were deemed urgent. If call-center triage recommendations were followed in even half of all cases, then these results would translate into substantial cost savings for the health care system.

Key Words: telephone medicine • telephone triage • call center • health care use

Abbreviations: ED—emergency department • HMO—health maintenance organizations • PACC—Pediatric After-hours Call Center • UCC—urgent care center • MEPS—Medical Expenditure Panel Survey

Accepted Sep 1, 2006.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 AAP NewsHome page
A. R. Hertz
Payment for non-face-to-face care critical to success of patient-centered medical home
AAP News, May 1, 2009; 30(5): 16 - 16.
[Full Text] [PDF]

Home page
 Arch Pediatr Adolesc MedHome page
L. M. Sanders, S. Federico, P. Klass, M. A. Abrams, and B. Dreyer
Literacy and Child Health: A Systematic Review
Arch Pediatr Adolesc Med, February 1, 2009; 163(2): 131 - 140.
[Abstract] [Full Text] [PDF]