Evaluating patient compliance with nurse advice line recommendations and the impact on healthcare costs.

ABSTRACT

OBJECTIVE: To explore the effect of telephone triage and advice lines in uninsured and managed care populations served by a safety net system and to document the relationship between the patient's initial plan for healthcare, the nurse recommendation, and the patient's subsequent healthcare action. STUDY DESIGN: Prospective telephone survey. PATIENTS AND METHODS: Of 1538 calls to a nurse advice line in a 28-day period, 710 (46%) callers were selected to be surveyed. Of those, 278 (39%) were surveyed by telephone within 7 days of their call to assess patient compliance with recommendations, the patient's actual healthcare actions, and their satisfaction with the service. RESULTS: Patients' reported actions were classified as either (1) home care (46%), (2) clinic visit (27%), or (3) hospital visit (27%). Seventy percent of patients complied with nurse advice line recommendations. Most patient actions (68%) differed from their original healthcare plan, with many (46%) choosing a lower intensity of care. Changes from patients' original healthcare plans had a potential annual net savings of $322 249. CONCLUSION: The simple act of calling a nurse triage and advice line corresponds with a change in the reported actions of uninsured and managed care patients and a potential reduction in costs to the safety net system providing their healthcare.