Hotline fails to reduce hospital burden

A GOVERNMENT-BACKED medical hotline is having a minimal impact, if any, on reducing the burden on hospital emergency departments, a study has found.

More than half the callers to the healthdirect help line attended an emergency department despite a recommendation to the contrary, research published in the Medical Journal of Australia on Monday found.

The national 24-hour help line, launched in 2006, connects callers with a nurse to assess the patient and provide recommendations. It expanded last year to include GPs.

A study carried out by the Royal Perth Hospital emergency department from August 2008 to April 2009 traced admissions back to the helpline and found 52.4 per cent were patients who attended emergency despite being advised against it.

The lead authors, emergency physicians Dr Joseph Ng and Professor Daniel Fatovich, said the cost of running medical hotlines was often justified by promoting a reduction in pressure on emergency departments.

But previous studies had shown that telephone triage services had a limited impact on reducing attendances, the authors said.

One large review of multiple studies could not find a case where a hotline had decreased pressure on an emergency department, and another found a nurse helpline increased attendances, the authors said.

"Given the healthdirect referrals to the ED in our study represented fewer than two per cent of ED attendances, the impact of telephone triage is minimal," the study said.

Dr Ng said the number of patients going to an emergency department after being given alternative advice indicated an issue with access to after hours services.

"Maybe these patients were being told to go to their family doctor and they would have tried really hard to, but maybe these services are just not available out of hours," Dr Ng told AAP.

He said the study showed callers to the healthdirect service who attended the hospital emergency department were more likely to be younger and female than those who self-referred or were sent by their GP.

Associate Professor Patrick Bolton from the University of NSW said the study showed that a phone call did not seem to be answering patients' questions about whether a visit to an emergency department was required.

"Consideration must be given to whether healthdirect represents the best use of finite health dollars," Assoc Prof Bolton said in an accompanying editorial.

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