• Peter Sprivulis, Mary Carey, and Ian Rouse.
• Acute Demand Management Unit, State Health Emergency Services, Fremantle Hospital, Australia. peter.sprivulis@health.wa.gov.au
• Emerg Med Australas. 2004 Feb 1; 16 (1): 35-40.

ObjectiveEvaluation of compliance with advice and appropriateness of emergency presentation following contact with a telephone triage service (HealthDirect).MethodsCompliance rates, triage distributions and admission rates were determined using linked HealthDirect and ED records for patients living within 2 km of an ED that presented during 2000.ResultsOf 13 019 presentations, 842 (6.5%) were HealthDirect contacts. In the HealthDirect group there were a greater proportion of patients under the age of 15 (290, 34% vs 1598, 13.1%) and women (481, 57% vs 5610, 46%). The triage distributions and admission rates for HealthDirect contacts and other patients were similar (HealthDirect 37.6% admitted, 95% CI 34-41, others 38.4% admitted, 95% CI 38-39, Pchi2 = 0.67). Of 3996 callers to HealthDirect, 3167 (79%) complied with advice with 963 (61%) complying with advice to present and 212 (9%, 95% CI 8-10%) presenting despite advice to defer presentation. Triage distributions and admission rates for compliers and non-compliers were similar (compliers 38% admitted, 95% CI 34-41, non-compliers, 37% admitted, 95% CI 30-44, Pchi2 = 0.89).ConclusionsHealthDirect contacts were of similar appropriateness to non-HealthDirect presenters and appear to attend the ED independent of HealthDirect advice. HealthDirect has a limited capacity to influence ED utilization or workload.

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