Quarterly QUARTER 1 Report - Healthdirect...NATIONAL HEALTH CALL CENTRE NETWORK I QUARTERLY REPORT I...

QUARTER 1 2012Quarterly

Report

National Health Call Centre Network Ltd (ABN 28 118 291 044) was established, and is jointly funded, by the Australian Government and the governments of the Australian Capital Territory, New South Wales, Northern Territory, South Australia, Tasmania and Western Australia. It is a public company limited by shares and is responsible for delivering the services of the National Health Call Centre Network by contracting with service providers and managing ongoing operations.

ForewordI am pleased to present the National Health Call Centre Network report for the period January to March 2012. This report outlines call data from the Network’s core services to give a snapshot of how Australians use the service.

The establishment of a National Health Call Centre Network (the Network) is an initiative of the Council of Australian Governments (COAG). The Network was formed in 2006 to provide the community with access to healthcare information and advice without time or geographic restrictions.

The purpose of the Network is to help people make informed decisions about their healthcare through access to accurate information. It facilitates people taking the most appropriate course of action for their situation; be it administering self care at home, seeing their GP the next day or presenting at an Emergency Department. The service is available 24 hours a day, seven days a week. It is not intended for emergency situations requiring Triple Zero (000).

This report contains data from the Network’s three core services:

1. healthdirect Australia

Registered Nurses provide 24 hour a day, seven day a week telephonic health advice and information to people calling from the ACT, NSW, the NT, SA, Tasmania and WA.

2. after hours GP helpline

The after hours GP helpline is intended as an additional service to existing after hours medical facilities.

Callers to the nurse triage services healthdirect Australia, NURSE-ON-CALL and 13 HEALTH have their condition assessed by a Registered Nurse. If appropriate, the nurse transfers their call to a telephone-based GP. The GP assesses the caller’s condition and provides medical advice. If a caller needs to see a health professional immediately, they will be referred to the most appropriate local face-to-face after hours services. If the call is an emergency, it will be transferred to Triple Zero (000).

Victoria and Queensland joined the after hours GP helpline in the first half of 2012, giving all Australians access to telephonic health advice from registered and accredited GPs (Tasmanian callers have access to after hours GP advice through the GP Assist service).

3. Pregnancy,Birth&BabyHelpline

General advice and counselling about pregnancy, childbirth and parenting in the first year; which is available to all Australians. This 24-hour a day, seven day a week telephonic service provides an entry point to information and support for women, their partners and families; as well as direction to maternity-related services incorporating specialist and support services.

Quality information is provided on topics such as maternal nutrition, breastfeeding, a baby’s development and sleeping habits. Callers experiencing emotional distress and general antenatal and perinatal issues can speak with a qualified counsellor. Professional nondirective counselling is also available to callers seeking information and support on pregnancy options.

Together with the online health information website, healthinsite (www.healthinsite.gov.au), the Network’s purpose is to ensure that Australians are advised on the appropriate care for their health issue when they need it and where they need it.

ColinSeeryCEONationalHealthCallCentreNetwork

Contents

1.healthdirect Australia 6

1.1 Number of calls 6

1.1.1 Calls handled 6

1.1.2 Call type 6

1.2 Time of calls 7

1.2.1 Time of day 7

1.2.2 Day of week 7

1.3 Age and gender 7

1.4 Caller relationship to patient 8

1.5 Location 8

1.6 Aboriginal and Torres Strait Islander callers 8

1.7 Interpreter and hearing services 8

1.8 Clinical issues 9

1.9 Advice 9

2.after hours GP helpline 10


2.2 Time of calls 11

2.2.1 Time of day 11

2.2.2 Day of week 12



2.5 Location 13



2.8 Clinical issues 13

2.9 Advice 14

3.Pregnancy,Birth&BabyHelpline 15


3.2 Time of calls 15

3.2.1 Time of day 15

3.2.2 Day of week 16



3.5 Location 16



3.8 Types of information requested 17

3.9 Advice 18

The right advice, support and services when and where you need it

6 I healthdirect Australia

The following statistics pertain to calls handled by the telephone nurse triage service, healthdirect Australia for the period January - March 2012 (Q1 2012). healthdirect Australia operates in the ACT, NSW, the NT, SA, Tasmania and WA.

1.1 Number of calls

1.1.1 Calls handledhealthdirect Australia handled 205,721 calls in Q1 2012 (Fig 1).

0

20

40

60

80

Mar-12Feb-12Jan-12

71,010

64,78669,925

‘000

s

Figure 1: Calls per month (healthdirect Australia)

Q1 2012 showed a 1% increase on the previous quarter (Q4 2011 – 204,173) and a 17% increase on the same period in 2011 (Q1 2011 – 176,044) (Fig 2).

0

50

100

150

200

250

Q12012

Q42011

Q12011

176,044

204,173 205,721

‘000

s

Figure 2: Calls per quarter (healthdirect Australia)

1.1.2 Call typeIn Q1 2012 the majority of calls were triaged (83.1%), followed by a request for information (9.9%), a quick call (4.2%), provider referral (2.7%) and assessed as emergency (0.1%). Quick calls include compliments / complaints, wrong numbers and media enquiries (Fig 3).

Quick call

Health information

Triage

Assessed as emergency

Provider referral

83.1%

9.9%

4.2%2.7% 0.1%

Figure 3: Call type (healthdirect Australia)

1. healthdirect AustraliaNurse triage

NATIONAL HEALTH CALL CENTRE NETWORK I QUARTERLY REPORT I QUARTER 1 2012 7


1.2 Time of calls

1.2.1 Time of dayIn Q1 2012 the most frequent call time was 8.00pm while the least frequent call time was 5.00am (times are AEST / AEDST). The period 6.00pm – 11.00pm had the heaviest call traffic (35%) (Fig 4).

0

5

10

15

20

9 PM8 PM

11 PM

10 PM

7 PM6 PM

5 PM4 PM

3 PM2 PM

1 PM

12 PM

11 AM

10 AM

9 AM8 AM

7 AM6 AM

5 AM4 AM

3 AM2 AM

1 AM

12 AM

‘000

s

Figure 4: Calls per hour (healthdirect Australia)

1.2.2 Day of weekIn Q1 2012 Sunday was the busiest day (17% calls), followed by Saturday (15.6%) and Monday (14.4%). Friday had the lowest volume of calls (13%) (Fig 5).

0

5

10

15

20

SunSatFriThuWedTueMon

14.413.4 13.4 13.2 13.0

15.617.0

%

Figure 5: Calls per day (healthdirect Australia)

1.3 Age and genderCallers and patients are not necessarily the same person; for example a mother might call on behalf of a child. The information in this section pertains to the patient.

In Q1 2012 63% of patients were female and 37% male. 27% of calls were made on behalf of a child aged 0-4 years; representing a significantly higher proportion of patients than any other age group for both females and males (Fig 6).

0

5

10

15

20

25

30Male patients

Female patients

65-69

60-64

55-59

50-54

45-49

40-44

35-39

30-34

25-29

20-24

15-19

10-145-90-4

70-74

75-79

›80

‘000

s

Figure 6: Patients by age and gender (healthdirect Australia)

8 I healthdirect Australia

1.6 Aboriginal and Torres StraitIslander callersIn Q1 2012 3.1% of callers identified themselves as being Aboriginal or Torres Strait Islander (Table 2).

Cultural background %

Aboriginal/Torres Strait Islander 3.1

Not Aboriginal or Torres Strait Islander 82.9

Declined 14

Table 2: Cultural background (healthdirect Australia)

1.7 Interpreter and hearing servicesIn Q1 2012, 24 people required the services of an interpreter and 13 used the National Relay Service.

1.4 Caller relationship to patientIn Q1 2012 the majority of calls were made for concerns about personal health (60.6%) (Table 1).

Relationship of caller to patient %

Self 60.6

Parent 32.8

Wife / partner 1.8

Child 1.2

Husband / partner 1

Table 1: Top 5 caller-to-patient relationships (healthdirect Australia)

1.5 LocationIn Q1 2012 the highest number of patients originated from New South Wales (86,340); followed by Western Australia (48,778) and South Australia (25,381). 79% of patients were from metropolitan areas (Fig 7). N/A represents postcode data that was not available or collected.

ACT

NSW N

T

SA TAS

WA

N/A

48,788

5555

25,381

2608

86,340

7721

25,291

‘000

s

RemoteN/A

RuralMetro

0

20

40

60

80

100

Figure 7: Patients by location (healthdirect Australia)



1.9 AdviceIn Q1 2012 the most frequent types of advice given by triage nurses were ‘See a health provider within 24 hours’ (21.5%), ‘Carry out self care at home’ (21.1%) or ‘See a health provider within four hours’ (18.5%). 14.1% of callers were advised that the patient should attend an emergency department immediately, while 4.7% of calls were transferred to Triple Zero (000) (Table 4).

Recommendation / advice %

See Doctor / health provider within 24 hours 21.5

Self care at home 21.1


Attend Emergency Department immediately 14.1

See Doctor / health provider immediately 11.5


Activate Triple Zero (000) 4.7

See Doctor / health provider within 2 weeks 1.8

Call Poisons Information Centre immediately 1.3

See mental health provider immediately neg.

Table 4: Recommendation / advice (healthdirect Australia)

1.8 Clinical issuesWhere clinically appropriate, medical issues are categorised as adult or paediatric (child).

In Q1 2012 the most common clinical issues addressed by a triage nurse were medication queries, vomiting by a child and chest pain (Table 3).

P represents paediatric conditions.

Clinical issue

1 Medication query

2 Vomiting (P)

3 Chest pain

4 Abdominal pain

5 Head trauma (P)

6 Fever (P)

7 Bites and stings

8 Diarrhoea (P)

9 Pregnancy concerns

10 Rash (P)

11 Postoperative problems

12 Colds (P)

13 Tooth, gum and jaw symptoms

14 Cough (P)

15 Nausea / vomiting

16 Headache

17 Bites and stings (P)

18 Poisoning (P)

19 Abrasions / lacerations

20 Poison information

Table 3: 20 most common clinical issues (healthdirect Australia) “InQ12012themostcommonclinicalissueforhealthdirect Australiawasamedicationquery

10 I after hours GP helpline

The after hours GP helpline is available to all Australians. The service operates between:

• 6.00pm – 8.00am Monday to Saturday,

• 12.00pm Saturday – 8.00am Monday, and

• 24 hours a day on public holidays.

Callers to healthdirect Australia during after hours GP helpline operating hours may be transferred to a GP when a triage nurse

2.after hours GP helplineCalls referred from healthdirect Australia nurses

Figure 8: Flow of calls to the after hours GP helpline (Q1 2012)

healthdirect Australia Nurse Triage

205,721

Referredtoafter hours GP helpline

36,436 24%

Operatinghours52,749

26%

Afterhours152,972

74%

Referredtoimmediateface-to-facecare

13,36237%

determines it is clinically appropriate. The GP will then decide if immediate face-to-face care is needed (activate Triple Zero (000), go to an Emergency Department immediately or see GP immediately).

In Q1 2012, 22,254 calls transferred to the after hours GP helpline were assessed by a triage nurse as requiring face-to-face care within four hours. Of those calls, the GPs determined that only 13,362 required immediate face-to-face care following an after hours GP helpline consultation. This represents a 40% reduction in the number of callers requiring immediate face-to-face care (Fig 8).

The following statistics pertain to the after hours GP helpline for the period January - March 2012 (Q1 2012).

Requiring face-to-face care within 4 hours: 22,254

Requiring face-to-face care within 24 hours: 14,182

Managedbyatelephone-basedGP

23,07463%

Managedbyatriagenurse116,536

76%



2.1 Number of callsThe after hours GP helpline handled 36,436 calls in Q1 2012 (Fig 9).

0

3

6

9

12

15

Mar-12Feb-12Jan-12

13,825

11,404 11,207

‘000

s

Figure 9: Calls per month (after hours GP helpline)

Q1 2012 showed a 17% decrease on the previous quarter (Q4 2011 – 44,083) (Fig 10). Note that the after hours GP helpline commenced operations on 1 July 2011.

0

10

20

30

40

50

Q12012

Q42011

44,083

36,436

‘000

s

Figure 10: Calls by quarter (after hours GP helpline)

2.2 Time of calls

2.2.1 Time of day In Q1 2012 the most frequent call time was 9.00pm while the least frequent call time was 8.00am (times are AEST/AEDST). The period 7.00pm – midnight had the heaviest call traffic (45%) (Fig 11). Note that calls between 8.00am and 6.00pm reflect calls that were transferred on weekends and public holidays.

0

1000

2000

3000

4000

9 PM8 PM

11 PM

10 PM

7 PM6 PM

5 PM4 PM

3 PM2 PM

1 PM

12 PM

11 AM

10 AM

9 AM8 AM

7 AM6 AM

5 AM4 AM

3 AM2 AM

1 AM

12 AM

Figure 11: Calls per hour (after hours GP helpline)


0

1000

2000

3000

4000

5000

6000Male patients

Female patients

65-69

60-64

55-59

50-54

45-49

40-44

35-39

30-34

25-29

20-24

15-19

10-145-90-4

70-74

75-79

›80

Figure 13: Patients by age and gender (after hours GP helpline)

2.4 Caller relationship to patientIn Q1 2012 the majority of calls were made for concerns about personal health (self ) (53.5%) (Table 5).


Self 53.5

Parent 37.4

Wife / partner 3.1

Child 1.9

Husband / partner 1.7

Table 5: Top 5 caller-to-patient relationships (after hours GP helpline)

2.2.2 Day of weekIn Q1 2012 Sunday was the busiest day (24.6% calls), followed by Saturday (17.9%) and Monday (13.7%). Friday had the lowest volume of calls (10.4%) (Fig 12).

0

5

10

15

20

25


13.7

11.2 10.611.6

10.4

17.9

24.6

%

Figure 12: Calls per day (after hours GP helpline)

2.3 Age and genderCallers and patients are not necessarily the same person; for example a mother might call on behalf of a child. The information in this section pertains to the patient.

In Q1 2012 61% of patients were female and 39% male. 28% of calls were made on behalf of a child aged 0-4 years; representing for both females and males a significantly higher proportion of patients than any other age group (Fig 13).

“InQ12012themostfrequentcalltimetotheafter hours GP helpline was9.00pm



2.7 Interpreter and hearing servicesThree callers required the services of an interpreter and 11 callers used the National Relay Service.

2.8 Clinical issuesWhere clinically appropriate, specific conditions are categorised as adult or paediatric (child).

In Q1 2012 the most common clinical issues addressed by the after hours GP helpline were abdominal pain, headache and vomiting. If the number of enquiries about vomiting for adults and children is combined, this becomes the single largest clinical issue (Table 7).

P represents paediatric conditions.

Clinical issue

1 Abdominal pain

2 Headache

3 Vomiting (P)

4 Fever (P)

5 Rash

6 Diarrhoea

7 Vomiting

8 Dizziness / vertigo

9 Cough (P)

10 Chest pain

11 Back symptoms

12 Diarrhoea (P)

13 Bloody urine

14 GI bleeding

15 Urinary symptoms: female

16 Croup (P)

17 Neurological symptoms

18 Crying baby 3 months (P)

19 Sore throat

20 Postoperative problems

Table 7: 20 most common clinical issues (after hours GP helpline)

2.5 LocationIn Q1 2012 the highest number of patients originated from New South Wales (18,049), followed by Western Australia (10,392) and South Australia (5817). 79% of patients were from metropolitan areas (Fig 14). N/A represents postcode data that was not available or collected.

ACT

NSW N

T

*QLD SA TA

S

WA

N/A

71 154

5817

641 125

18,049

1727

10,392

‘000

s

0

5

10

15

20

RemoteN/A

RuralMetro

Figure 14: Patients by location (after hours GP helpline)* The after hours GP helpline commenced in Queensland on 6 March 2012

Victoria joined the after hours GP helpline on 30 April 2012.



Aboriginal/Torres Strait Islander 3.6


Declined 3.4

Table 6: Cultural background (after hours GP helpline)


2.9 AdviceIn Q1 2012 the most frequent types of advice given by GPs on the after hours GP helpline were ‘Self care and see a Doctor or health provider within normal operating hours’ (51.4%), ‘See a GP immediately’ (19.6%) and ‘Attend an Emergency Department immediately’ (15.5%). 1.6% of calls were transferred to Triple Zero (000) (Table 8).


Self care advice and see a Doctor / health provider within normal operating hours

51.4

GP immediately 19.6

Emergency Department immediately 15.5

Self care at home 8.4

No recommendation / advice reached 3.5

Activate Triple Zero (000) 1.6

Mental health referral neg.

Table 8: Recommendation / advice (after hours GP helpline)

7.5% of patients were initially advised to see a GP immediately, however when it was ascertained that there was no GP available, they were advised to go to an Emergency Department.

InQ1201228.2%ofcallstotheafter hours GP helpline weremadeonbehalfofachildaged0-4years“


3. Pregnancy, Birth & Baby Helpline

0

2

4

6

8

10

12

Q12012

Q42011

Q12011

7282

11,50010,974

‘000

s

Figure 16: Calls per quarter (Pregnancy, Birth & Baby Helpline)

3.2 Time of calls

3.2.1 Time of dayIn Q1 2012 the most frequent call time was 5.00pm while the least frequent was 6.00am (times are AEST/AEDST). 73% of calls occured between 10.00am and 10.00pm (Fig 17).

0

200

400

600

800

9 PM8 PM

11 PM

10 PM

7 PM6 PM

5 PM4 PM

3 PM2 PM

1 PM

12 PM

11 AM

10 AM

9 AM8 AM

7 AM6 AM

5 AM4 AM

3 AM2 AM

1 AM

12 AM

Figure 17: Calls per hour (Pregnancy, Birth & Baby Helpline)

The following statistics pertain to calls handled by the Pregnancy, Birth & Baby Helpline for the period January - March (Q1 2012). The Pregnancy, Birth & Baby Helpline is available to all Australians.

3.1 Number of callsThe Pregnancy, Birth & Baby Helpline received 10,974 calls in Q1 2012 (Fig 15).

0

1000

2000

3000

4000

Mar-12Feb-12Jan-12

37853476

3713

Figure 15: Calls per month (Pregnancy, Birth & Baby Helpline)

Q1 2012 had 5% fewer calls than the previous quarter (Q4 2011 – 11,500) and showed a 51% increase on the same period in 2011 (Q1 2011 – 4809) (Fig 16).

3.Pregnancy,Birth&BabyHelplineGeneral advice and counselling

16 I Pregnancy, Birth & Baby Helpline

3.4 Caller relationship to patientIn Q1 2012 the majority of calls were made by a mother on behalf of a child (57.9%) (Table 9).


Mother 57.9

Father 9.9

Husband / male partner 3.3

Table 9: Top 3 caller-to-patient relationships (Pregnancy, Birth & Baby Helpline)

3.5 LocationIn Q1 2012 the highest number of callers originated from New South Wales (3225), followed by South Australia (1953) and Victoria (1745). 82% of calls were from metropolitan areas (Fig 20). N/A represents postcode data that was not available or collected.

ACT

NSW N

T

QLD SA TA

S

VIC

WA

N/A

191

1953

1276

68

3225

275

1422

819

0

1000

2000

3000

1745

RemoteN/A

RuralMetro

Figure 20: Callers by location (Pregnancy, Birth & Baby Helpline)

3.2.2 Day of weekIn Q1 2012 Monday was the busiest day (15.5% of calls), followed by Tuesday and Wednesday (15.2% of calls respectively). Sunday had the lowest volume of calls (12.4%) (Fig 18).

0

5

10

15

20


15.5 15.2 15.214.5

13.8 13.512.4

%

Figure 18: Calls per day (Pregnancy, Birth & Baby Helpline)

3.3 Age and genderCallers and patients are not necessarily the same person; for example a mother might call on behalf of a child. The information in this section pertains to the caller.

In Q1 2012 82% of callers were female and 12% male. 6% of callers elected not to disclose their gender.

The most common age groups for female callers were 30-34 (30%), 25-29 (24%) and 35-39 (15.5%). The most common age groups for male callers were 30-34 (5%), 25-29 (3%) and 35-39 (2%) (Fig 19).

0

50

100

150

200

250

300Male callers

Female callers

65-69

60-64

55-59

50-54

45-49

40-44

35-39

30-34

25-29

20-24

15-19‹15

70-74

75-79

›80

Figure 19: Caller age and gender (Pregnancy, Birth & Baby Helpline)


3. Pregnancy, Birth & Baby Helpline

3.8 Types of information requestedIn Q1 2012 the most common types of information requested were regarding the topics of maternal and child health, constipation and the Australian Breastfeeding Association (Table 11).

Type of information requested

1 Maternal and child health

2 Constipation

3 Australian Breastfeeding Association

4 Drugs and alcohol

5 Feeding: bottle

6 Feeding: solids

7 Feeding: breast

8 Crying baby

9 General enquiries about the service

10 Hospitals

11 Sleep: birth to 3 months

12 Sleep: 6 months

13 Tooth development and teething

14 Sleep: 3 - 6 months

15 Sudden Infant Death Syndrome (SIDS)

16 Family welfare

17 Babies and hot weather

18 Sleeping safely

19 Maternal and child health

20 Eating well during pregnancy

Table 11: Top 20 types of information requested (Pregnancy, Birth & Baby Helpline)



Aboriginal / Torres Strait Islander 1.6


Declined 14.9

Table 10: Cultural background (Pregnancy, Birth & Baby Helpline)

3.7 Interpreter and hearing servicesFour callers required the services of an interpreter and one caller required hearing assistance services.

“InQ12012MondaywasthebusiestdayforcallstothePregnancy,Birth&BabyHelpline

18 I Pregnancy, Birth & Baby Helpline

3.9 AdviceIn Q1 2012 the most common types of advice or recommendations given were ‘Referral to a Nurse’ (69.1%), ‘Supply of pregnancy and perinatal fact sheet’ (10.4%) and ‘General counselling’ (7.4%) (Table 12).


Referral to a Nurse 69.1

Supply of pregnancy and perinatal fact sheets 10.4

General counselling 7.4

Health provider contact details 6.6

Referral to a pregnancy / perinatal support agency 2.2

Referred back to a treating medical professional 2

Pregnancy counselling 1.5

Counselling: enquiry neg.

Activate Triple Zero (000) neg.

Table 12: Recommendation / advice (Pregnancy, Birth & Baby Helpline)

“InQ12012themostfrequentcalltimetothePregnancy,Birth&BabyHelplinewas5:00pm

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