• Rosemary McKenzie, David Dunt, and Allison Yates.
• Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia. r.mckenzie@unimelb.edu.au.
• Emerg Med Australas. 2016 Oct 1; 28 (5): 538-43.

ObjectiveTo determine ED attendance and compliance with GP advice following a call to an after hours telephone triage and advice service.MethodsA descriptive study of users' of an after hours helpline self-reported ED attendance and compliance with GP recommendation, based on routinely collected service data and telephone survey results for 2783 callers in 2011-2012. The outcome measure was self-reported health service utilisation following advice from a GP on an after hours helpline.ResultsOne-third of the sample - 934 callers - intended to visit the ED. Of these, 504 (54%, 95% CI 50.7%-57.2%) reported taking other less urgent options. The GP assessment confirmed the original intention for 224 callers (24%, 95% CI 21.2%-26.9%). However, 151 patients (16%, 95% CI 13.8%-18.6%) did attend the ED as they had originally intended despite the GP's recommendation to seek less serious care, whereas a further 55 patients (6%, 95% CI 4.4%-7.6%) assessed by the GP as requiring ED care chose a less serious option. Fifty-five per cent of all callers who attended ED did not intend to visit the ED prior to their call. The overall net result was a small reduction in ED attendance compared with original intentions.ConclusionAn after hours GP helpline may divert some callers intending to go to the ED to other care. However, patient non-compliance may limit the capacity of telephone triage and advice service to reduce demand for ED. Further research is needed to better understand the effect of the service.© 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

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