Effectiveness of telephone-based screening and triage during COVID-19 outbreak in the promoted primary healthcare system: a case study in Ardabil province, Iran

doi:10.1007/s10389-020-01407-8

. 2022;30(5):1301-1306.

doi: 10.1007/s10389-020-01407-8. Epub 2020 Nov 13.

Effectiveness of telephone-based screening and triage during COVID-19 outbreak in the promoted primary healthcare system: a case study in Ardabil province, Iran

Nazila NeJhaddadgar¹, Arash Ziapour², Ghader Zakkipour³, Jaffar Abbas⁴, Mitra Abolfathi⁵, Masoud Shabani⁶

Affiliations

¹ Department of Health Promotion and Education, Ardabil University of Medical Sciences, Ardabil, Iran.
² Health Education and Health Promotion, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
³ Fellowship of National Health & Treatment Network Management, Ardabil University of Medical Sciences, Ardabil, Iran.
⁴ Antai College of Economics and Management/School of Media and Communication, Shanghai Jiao Tong University, Shanghai, China.
⁵ Department of Health Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
⁶ Fellowship of National Health & Treatment Network Management, Department of Community Dentistry, School of Dentistry, Ardabil University of Medical Sciences, Ardabil, Iran.

PMID: 33224715
PMCID: PMC7665795
DOI: 10.1007/s10389-020-01407-8

Effectiveness of telephone-based screening and triage during COVID-19 outbreak in the promoted primary healthcare system: a case study in Ardabil province, Iran

Nazila NeJhaddadgar et al. Z Gesundh Wiss. 2022.

. 2022;30(5):1301-1306.

doi: 10.1007/s10389-020-01407-8. Epub 2020 Nov 13.

Authors

Nazila NeJhaddadgar¹, Arash Ziapour², Ghader Zakkipour³, Jaffar Abbas⁴, Mitra Abolfathi⁵, Masoud Shabani⁶

Affiliations

¹ Department of Health Promotion and Education, Ardabil University of Medical Sciences, Ardabil, Iran.
² Health Education and Health Promotion, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
³ Fellowship of National Health & Treatment Network Management, Ardabil University of Medical Sciences, Ardabil, Iran.
⁴ Antai College of Economics and Management/School of Media and Communication, Shanghai Jiao Tong University, Shanghai, China.
⁵ Department of Health Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
⁶ Fellowship of National Health & Treatment Network Management, Department of Community Dentistry, School of Dentistry, Ardabil University of Medical Sciences, Ardabil, Iran.

PMID: 33224715
PMCID: PMC7665795
DOI: 10.1007/s10389-020-01407-8

Abstract

Aims: Screening services for early detection of patients is one of the important capabilities of the health system with a proper referral system. In the crisis of respiratory infection of Covid-19, screening based on symptoms is one of the key measures. The aim of the current study was to evaluate the telephone-based screening and triage services in the promoted primary healthcare system with regard to the Covid-19 outbreak, in terms of reducing unnecessary referrals to the hospital.

Methods: This is a descriptive cross-sectional study conducted in two stages on 1,406,635 households during March/April 2020 in Ardabil province for screening and early detection of Covid-19 disease. In the first stage, conducted by trained healthcare providers through telephone, individuals suspected of Covid-19 were identified. In the second stage, the individuals were referred to the second level of service in comprehensive healthcare centers (16- or 24-h centers) for clinical evaluation by a physician.

Results: The results showed that before establishing a screening and triage system for patients in comprehensive healthcare centers, all patients were referred directly to the hospital, while after the implementation of the program, a significant reduction in hospital visits was observed and a large number of patients undertook the care and triage services in comprehensive healthcare centers.

Conclusion: The use of a grading system in referring patients with suspected cases, triage of patients according to symptoms at the comprehensive health centers, and activation of home isolation were the most important factors in reducing the burden of unnecessary referrals of patients to the hospital.

Keywords: Comprehensive health centers; Covid-19; Screening; Triage.

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Conflict of interest statement

Conflict of interestThe authors declare that they have no conflict of interest.

Figures

**Fig. 1**
Clients of the hospital due to Covid-19 from 5 to 25 March. This figure shows the high number of hospital visits

**Fig. 2**
Clients of the hospital due to Covid-19 from March 17 to April 4. In this figure, an intervention has been performed that has reduced the burden of hospital visits and has led people with symptoms to health centers

See this image and copyright information in PMC

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References

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[1] Azamar-Alonso A, Costa AP, Huebner LA, Tarride JE. Electronic referral systems in health care: a scoping review. Clinicoecon Outcomes Res. 2019;11:325–332. doi: 10.2147/CEOR.S195597. - DOI - PMC - PubMed

[2] Azamar-Alonso A, Costa AP, Huebner LA, Tarride JE. Electronic referral systems in health care: a scoping review. Clinicoecon Outcomes Res. 2019;11:325–332. doi: 10.2147/CEOR.S195597. - DOI - PMC - PubMed

[3] Ebadi Fard Azar F (2011) Health service principles. 2nd ed. Gisom. pp 63–81

[4] Ebadi Fard Azar F (2011) Health service principles. 2nd ed. Gisom. pp 63–81

[5] Fort MP, Grembowski D, Heagerty P, Lim SS, Mercer MA. Evaluation of a demonstration primary health care project in rural Guatemala: the influence of predisposing, enabling and need factors on immunization coverage, equitable use of health care services and application of treatment guidelines. Int Health. 2012;4(3):220–228. doi: 10.1016/j.inhe.2012.04.001. - DOI - PubMed

[6] Fort MP, Grembowski D, Heagerty P, Lim SS, Mercer MA. Evaluation of a demonstration primary health care project in rural Guatemala: the influence of predisposing, enabling and need factors on immunization coverage, equitable use of health care services and application of treatment guidelines. Int Health. 2012;4(3):220–228. doi: 10.1016/j.inhe.2012.04.001. - DOI - PubMed

[7] Ge Y, McKay BK, Sun S, Zhang F, Handel A. Assessing the impact of a symptom-based mass screening and testing intervention during a novel infectious disease outbreak: the case of COVID-19. MedRxiv. 2020;12:1–5. doi: 10.1101/2020.02.20.20025973. - DOI

[8] Ge Y, McKay BK, Sun S, Zhang F, Handel A. Assessing the impact of a symptom-based mass screening and testing intervention during a novel infectious disease outbreak: the case of COVID-19. MedRxiv. 2020;12:1–5. doi: 10.1101/2020.02.20.20025973. - DOI

[9] Ji Y, Ma Z, Peppelenbosch MP, Pa Q. Potential association between COVID-19 mortality and health-care resource availability. Lancet Glob Health. 2020;8(4):e480. doi: 10.1016/S2214-109X(20)30068-1. - DOI - PMC - PubMed

[10] Ji Y, Ma Z, Peppelenbosch MP, Pa Q. Potential association between COVID-19 mortality and health-care resource availability. Lancet Glob Health. 2020;8(4):e480. doi: 10.1016/S2214-109X(20)30068-1. - DOI - PMC - PubMed

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Effectiveness of telephone-based screening and triage during COVID-19 outbreak in the promoted primary healthcare system: a case study in Ardabil province, Iran

Affiliations

Effectiveness of telephone-based screening and triage during COVID-19 outbreak in the promoted primary healthcare system: a case study in Ardabil province, Iran

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

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References

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