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Effectiveness of a 24/7 Nurse Advice Line in Reducing Non-Emergent Visits to the Emergency Room in Rural New Mexico

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Please use this identifier to cite or link to this item: http://hdl.handle.net/1928/10875

Effectiveness of a 24/7 Nurse Advice Line in Reducing Non-Emergent Visits to the Emergency Room in Rural New Mexico

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Title: Effectiveness of a 24/7 Nurse Advice Line in Reducing Non-Emergent Visits to the Emergency Room in Rural New Mexico
Author: Bissell, Elena.; Fiorenzio, C.; Johnson, A.; Kaufman, Arthur.; Skipper, Betty.; Wagner, L.
Subject: Nurse Advice Line
Rural healthcare access
Emergency room use
Abstract: New Mexico is a poor and medically underserved state, with 30 of its 33 counties designated as Health Professional Shortage Areas. Individuals residing outside of the major urban centers (Albuquerque, Santa Fe, and Las Cruces) are sicker, seek care later in their illness, make greater use of the emergency room and urgent care centers and have to travel considerable distances to urban centers to seek specialty services not available in their county. One consequence is overuse of emergency departments by uninsured and non-urgent patients and over-hospitalization for primary care-preventable conditions. This results in fragmented healthcare and a great financial burden for patients and hospitals. The University of New Mexico Department of Family and Community Medicine worked with a consortium of safety net provider organizations to develop a statewide, 24-hour triage call center (NurseAdvice New Mexico) to offer every New Mexican an opportunity to access healthcare advice regardless of insurance status or geographic location. Preliminary data on the Line’s impact on callers from Albuquerque demonstrated that the Advice Line diverted medically unnecessary emergency department visits to primary care providers. However, the impact of the Line in rural New Mexico has not been studied. The purpose of the study was to measure the NurseAdvice Line’s impact on non-urgent visits to EDs in four rural, southwestern NM counties. Researchers were provided monthly lists of callers from the four counties between September 2008, and December 2008. The lists included the caller’s intent for seeking care upon calling NurseAdvice Line, the result of the triage conversation and the advice the caller received. The researchers telephoned callers whose initial intent was to go to the ED but were advised to seek primary care or administer self-care. These callers were asked the result of the encounter: whether they went to the ED or followed the advice given. Seventy-seven people were surveyed. Seventy percent (95% CI, 59-80%) followed the advice and did not go to the emergency department and 30% went to the emergency department despite the advice. This study demonstrated that the NurseAdvice Line was effective in diverting non-urgent patients to primary care or self-care in rural New Mexico. This diversion rate could result in substantial financial savings for patients and hospitals.
Date: 2010-01-29
Citation: Meeting Abstract: Effectiveness of a 24/7 Nurse Advice Line in Reducing Non-Emergency Visits to the Emergency Room in Rural New Mexico Journal of Investigative Medicine, Vol.58 (1) #86 page 126, 2010.
Description: Presented at the Western Regional Meeting of the American Federation for Medical Research held January 27-30, 2010, Carmel, CA.
URI: http://hdl.handle.net/1928/10875


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