Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Nov 9;17(1):706.
doi: 10.1186/s12913-017-2651-z.

Telephone triage utilization among patients with limited English proficiency

Jane W Njeru  1 , Swathi Damodaran  2 , Frederick North  3 , Debra J Jacobson  4 , Patrick M Wilson  4 , Jennifer L St Sauver  5 , Carmen Radecki Breitkopf  6 , Mark L Wieland  3
Affiliations

Telephone triage utilization among patients with limited English proficiency

Jane W Njeru et al. BMC Health Serv Res. .

Abstract

Background: Communication between patients with limited English proficiency (LEP) and telephone triage services has not been previously explored. The purpose of this study was to determine the utilization characteristics of a primary care triage call center by patients with LEP.

Methods: This was a retrospective cohort study of the utilization of a computer-aided, nurse-led telephone triage system by English proficiency status of patients empaneled to a large primary care practice network in the Midwest United States. Interpreter Services (IS) need was used as a proxy for LEP.

Results: Call volumes between the 587 adult patients with LEP and an age-frequency matched cohort of English-Proficient (EP) patients were similar. Calls from patients with LEP were longer and more often made by a surrogate. Patients with LEP received recommendations for higher acuity care more frequently (49.4% versus 39.0%; P < 0.0004), and disagreed with recommendations more frequently (30.1% versus 20.9%; P = 0.0004). These associations remained after adjustment for comorbidities. Patients with LEP were also less likely to follow recommendations (60.9% versus 69.4%; P = 0.0029), even after adjusting for confounders (adjusted odds ratio [AOR] = 0.65; 95% confidence interval [CI], 0.49, 0.85; P < 0.001).

Conclusion: Patients with LEP who utilized a computer-aided, nurse-led telephone triage system were more likely to receive recommendations for higher acuity care compared to EP patients. They were also less likely to agree with, or follow, recommendations given. Additional research is needed to better understand how telephone triage can better serve patients with LEP.

Keywords: Immigrants and refugees; Interpreter services; Limited English proficiency; Telephone triage.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Only patients with an active Minnesota research authorization on file approving use of their medical records for research were included in this study [22].

Patient data were accessed only if they had an active Minnesota research authorization on file, allowing use of their medical records for research, and all study procedures were approved by the Mayo Clinic Institutional Review Board.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

    1. O'Connell JM, Johnson DA, Stallmeyer J, Cokingtin D. A satisfaction and return-on-investment study of a nurse triage service. Am J Manag Care. 2001;7(2):159–169. - PubMed
    1. Marklund B, Ström M, Mänson J, Borgquist L, Baigi A, Fridlund B. Computer-supported telephone nurse triage: an evaluation of medical quality and costs. J Nurs Manag. 2007;15(2):180–187. doi: 10.1111/j.1365-2834.2007.00659.x. - DOI - PubMed
    1. Charles-Jones H, May C, Latimer J, Roland M. Telephone triage by nurses in primary care: what is it for and what are the consequences likely to be? J Health Serv Res Policy. 2003;8(3):154–159. doi: 10.1258/135581903322029502. - DOI - PubMed
    1. Richards DA, Meakins J, Tawfik J, et al. Nurse telephone triage for same day appointments in general practice: multiple interrupted time series trial of effect on workload and costs. BMJ. 2002;325(7374):1214–1217. doi: 10.1136/bmj.325.7374.1214. - DOI - PMC - PubMed
    1. Campbell JL, Fletcher E, Britten N, et al. Telephone triage for management of same-day consultation requests in general practice (the ESTEEM trial): a cluster-randomised controlled trial and cost-consequence analysis. Lancet. 2014;384(9957):1859–1868. doi: 10.1016/S0140-6736(14)61058-8. - DOI - PubMed

LinkOut - more resources