Quarterly Report - Healthdirect · Quarterly Report Quarter 2 April - June 2012. National Health...

QuarterlyReport

Quarter 2

April - June 2012

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.

All registered nurses (RNs) and general practitioners (GPs) providing our services hold unconditional registration with the Australian Health Practitioner Registration Authority (AHPRA).

All GPs have unconditional registration with the Medical Board of Australia.

All RNs and GPs have a minimum of 3 years experience.

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

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

The purpose of the NHCCN 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 NHCCN’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, TAS and WA.

Since commencing operations in 2007, the healthdirect Australia service has surpassed three million calls.

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 provided by 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).

All Australians have access to telephonic health advice from registered and accredited GPs (Tasmanian callers have access to after hours GP advice through the GP Assist service).

Since commencing operations in July 2011, the after hours GP helpline service has exceeded 150,000 calls.

3. pregnancy, birth & baby helpline

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, breast feeding, a baby’s development and sleeping habits. Callers experiencing emotional distress and general antenatal and perinatal issues can speak with a qualified counsellor. Professional non-directive 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 NHCCN’s objective is to ensure that Australians are advised on the appropriate care for their health issue when they need it and where they need it.

Colin SeeryCEONational Health Call Centre Network

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 & baby helpline 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 April - June 2012 (Q2 2012). healthdirect Australia operates in the ACT, NSW, the NT, SA, TAS and WA.

1.1 Number of calls

1.1.1 Calls handledhealthdirect Australia handled 210,190 calls in Q2 2012 (Fig 1).

0

10

20

30

40

50

60

70

80

Jun-12May-12Apr-12

68,116 67,357

74,717

‘000

s

Figure 1: Calls per month (healthdirect Australia)

Q2 2012 showed a 2% increase on the previous quarter (Q1 2012 – 205,721) and a 17.5 % increase on the same period in 2011 (Q2 2011 – 178,916) (Fig 2).

0

50

100

150

200

250

Q2 2012 Q1 2012 Q2 2011

178,916

205,721 210,190

‘000

s

Figure 2: Calls per quarter (healthdirect Australia)

1.1.2 Call typeIn Q2 2012 the majority of calls were triaged (83.4%), followed by a request for information (9.9%), a quick call (4.1%), provider referral (2.6%) and assessed as emergency (neg.). Quick calls include compliments / complaints, wrong numbers and media enquiries (Fig 3).

Quick call

Health information

Triage

Assessed as emergency

Provider referral

83.4%

9.9%

4.1%2.6% neg.

Figure 3: Call type (healthdirect Australia)

1. healthdirect Australia Nurse triage

NATIONAL HEALTH CALL CENTRE NETWORk I QUARTERLy REPORT I QUARTER 2 2012 7


1.2 Time of calls

1.2.1 Time of dayIn Q2 2012 the most frequent call time was 7.00pm while the least frequent call time was 5.00am (times are AEST / AEDST). The period 6.00pm – 10.00pm had the heaviest call traffic (29%) (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 Q2 2012 Sunday was the busiest day (17% calls), followed by Saturday (15.6%) and Monday (14.3%). Tuesday had the lowest volume of calls (13.2%) (Fig 5).

0

5

10

15

20

SunSatFriThuWedTueMon

14.313.2 13.3 13.2 13.4

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 Q2 2012 62% of patients were female and 38% male. 29.5% 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).

5

10

15

20

25

30

35Male 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

0

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

“There was a 17.5% increase in calls to healthdirect Australia compared to the same period in 2011

8 I healthdirect Australia

1.6 Aboriginal and Torres StraitIslander callersIn Q2 2012 3.3% of callers identified themselves as being Aboriginal or Torres Strait Islander (Table 2).

Cultural background %

Aboriginal/Torres Strait Islander 3.3

Not Aboriginal or Torres Strait Islander 83.9

Declined 12.8

Table 2: Cultural background (healthdirect Australia)

1.7 Interpreter and hearing servicesIn Q2 2012, 29 people required the services of an interpreter and four used the National Relay Service.

1.4 Caller relationship to patientIn Q2 2012 the majority of calls were made for concerns about personal health (58.7%) (Table 1).

Relationship of caller to patient %

Self 58.7

Parent 35.5

Wife / partner 1.4

Table 1: Top 3 caller-to-patient relationships (healthdirect Australia)

1.5 LocationIn Q2 2012 the highest number of patients originated from New South Wales (96,120); followed by Western Australia (50,948) and South Australia (27,076). 80% 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

50,948

5852

27,076

2863

96,120

8261

24,406

‘000

s

RemoteN/A

RuralMetro

0

20

40

60

80

100

Figure 7: Patients by location (healthdirect Australia)



1.9 AdviceIn Q2 2012 the most frequent types of advice given by triage nurses were ‘See a health provider within 24 hours’ (22.9%), ‘Carry out self care at home’ (19.4%) or ‘See a health provider within 4 hours’ (19.1%). 13.8% 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 22.9

Self care at home 19.4


Attend emergency department immediately 13.8

See doctor / health provider immediately 11.9


Activate Triple Zero (000) 4.7

See doctor / health provider within 2 weeks 1.7

Call Poisons Information Centre immediately 1.2

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 Q2 2012 the most common clinical issues addressed by a triage nurse were medication queries, vomiting by a child and abdominal pain (Table 3).

(P) represents paediatric conditions.

Clinical issue

1 Medication query

2 Vomiting (P)

3 Abdominal pain

4 Chest pain

5 Cough (P)

6 Cold symptoms (P)

7 Fever (P)

8 Head trauma (P)

9 Diarrhoea (P)

10 Rash (P)

11 Pregnancy concerns

12 Postoperative problems

13 Headache

14 Respiratory symptoms (P)

15 Tooth, gum and jaw symptoms

16 Back symptoms

17 Nausea / vomiting

18 Dizziness / vertigo

19 Poisoning (P)

20 Neurological symptoms

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

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 helpline Calls referred from healthdirect Australia nurses

Figure 8: Flow of calls to the after hours GP helpline (Q2 2012)

healthdirect Australia Nurse triage

210,190

Referred to after hours GP helpline

29,745 19%

Operating hours 54,470

26%

After hours 155,720

74%

Referred to immediate face-to-face care

10,794 36%

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 Q2 2012, 19,133 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 10,794 required immediate face-to-face care following an after hours GP helpline consultation. This represents a 44% reduction in the number of callers requiring immediate face-to-face care (Fig 8).

Note that the analysis excludes calls transferred to the after hours GP helpline from 13 HEALTH in Queensland and NURSE-ON-CALL in Victoria.

Requiring face-to-face care within 4 hours: 19,133

Requiring face-to-face care within 24 hours: 10,612

Managed by a telephone-based GP

18,951 64%

Managed by a triage nurse 125,975

81%



The following statistics pertain to the after hours GP helpline for the period April - June 2012 (Q2 2012).

Note that the analysis includes calls transferred to the after hours GP helpline from 13 HEALTH in Queensland and NURSE-ON-CALL in Victoria.

2.1 Number of callsThe after hours GP helpline handled 37,149 calls in Q2 2012 (Fig 9).

0

3

6

9

12

15

Jun-12May-12Apr-12

11,770 11,411

13,968

‘000

s

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

Q2 2012 showed a 2% increase on the previous quarter (Q1 2012 – 36,436) (Fig 10).

Note that the after hours GP helpline commenced operations on 1 July 2011.

0

5

10

15

20

25

30

35

40

Q22012

Q12012

36,436 37,149

‘000

s

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

2.2 Time of calls

2.2.1 Time of day In Q2 2012 the most frequent call time was 8.00pm while the least frequent call time was 11.00am (times are AEST/AEDST). The period 6.00pm – midnight had the heaviest call traffic (60%) (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)


2.4 Caller relationship to patientIn Q2 2012 the majority of calls were made for concerns about personal health (self ) (53.1%) (Table 5).


Self 53.1

Parent 39.3

Wife / partner 2.0

Child 1.7

Husband / partner 1.5

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

2.2.2 Day of weekIn Q2 2012 Sunday was the busiest day (24.2% calls), followed by Saturday (18.1%) and Monday (13.5%). Tuesday had the lowest volume of calls (10.7%) (Fig 12).

0

5

10

15

20

25


13.5

10.7 11.2 10.9 11.4

18.1

24.2

%

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 Q2 2012 61% of patients were female and 39% male. 29.4% 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).

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)

“In Q2 2012 the after hours GP help line exceeded 150,000 calls



2.7 Interpreter and hearing servicesSeven 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 Q2 2012 the most common clinical issues addressed by the after hours GP helpline were respiratory symptoms (paediatric), vomiting and a rash. 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 Respiratory symptoms (P)

2 Vomiting

3 Rash

4 Cough (P)

5 Headache

6 Vomiting (P)

7 Diarrhoea

8 Gastrointestinal bleeding

9 Chest pain

10 Cold (P)

11 Postoperative problems

12 Asthma (P)

13 Sore throat

14 Bloody urine

15 Cough

16 Dizziness / vertigo

17 Urinary symptoms: female

18 Constipation (P)

19 Flank pain

20 Diarrhoea (P)

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

2.5 LocationIn Q2 2012 the highest number of patients originated from New South Wales (15,147), followed by Western Australia (8,066) and Victoria (6,976). 78.3% of patients who disclosed their location 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

*VIC

WA

N/A

751412

4569

6976

437 505

15,147

1422

8066‘000

s

0

5

10

15

20

RemoteN/A

RuralMetro

Figure 14: Patients by location (after hours GP helpline) *Victoria joined the after hours GP helpline on 30 April 2012



Aboriginal/Torres Strait Islander 3.6


Declined 3.6

Table 6: Cultural background (after hours GP helpline)


2.9 AdviceIn Q2 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’ (50.7%), ‘See a GP immediately’ (21.7%) and ‘Attend an emergency department immediately’ (12.9%). 1.4% of calls were transferred to Triple Zero (000) (Table 8).


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

50.7

See a GP immediately 21.7

Emergency department immediately 12.9

Self care at home 8.8

No recommendation / advice reached 4.4

Activate Triple Zero (000) 1.4

Mental health referral neg.

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

8% 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.

In Q2 2012 the most common clinical issue for after hours GP helpline callers was paediatric respiratory symptoms“



3.2 Time of calls

3.2.1 Time of dayIn Q2 2012 the most frequent call time was 6.00pm while the least frequent was 4.00am (times are AEST/AEDST). 79% of calls occured between 9.00am and 10.00pm (Fig 17).

0

100

200

300

400

500

600

700

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 April - June 2012 (Q2 2012). The pregnancy, birth & baby helpline is available to all Australians.

3.1 Number of callsThe pregnancy, birth & baby helpline received 9,792 calls in Q2 2012 (Fig 15).

0

500

1000

1500

2000

2500

3000

3500

Jun-12May-12Apr-12

31773338 3277

Figure 15: Calls per month (pregnancy, birth & baby helpline)

Q2 2012 had 11% fewer calls than the previous quarter (Q1 2012 – 10,974). (Fig 16).

0

2

4

6

8

10

12

Q22012

Q12012

Q22011

9786

10,974

9792

‘000

s

Figure 16: Calls per quarter (pregnancy, birth & baby helpline)

3. pregnancy, birth & baby helpline General advice and counselling

16 I pregnancy, birth & baby helpline

3.4 Caller relationship to patientIn Q2 2012 the majority of calls were made by a mother on behalf of a child (58.7%) (Table 9).


Mother 58.7

Father 10.1

Husband / male partner 3.0

Table 9: Top 3 caller-to-patient relationships (pregnancy, birth & baby helpline)

3.5 LocationIn Q2 2012 the highest number of callers originated from New South Wales (3037), followed by South Australia (1800) and Victoria (1389). 82.5% of callers 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

139

1800

1005

62

3037

264

1365

731

0

500

1000

1500

2000

2500

3000

3500

1389

RemoteN/A

RuralMetro

Figure 20: Callers by location (pregnancy, birth & baby helpline)

3.2.2 Day of weekIn Q2 2012 Thursday was the busiest day (15.2% of calls), followed by Monday and Tuesday (15.1% of calls respectively). Saturday had the lowest volume of calls (13.1%) (Fig 18).

0

5

10

15

20


15.1 15.114.3

15.214.0

13.1 13.2

%

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 Q2 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 (29.6%), 25-29 (24.3%) and 35-39 (14.2%). The most common age groups for male callers were 30-34 (4.8%), 35-39 (2.7%) and 25-29 (2.6%) (Fig 19).

0

500

1000

1500

2000

2500Male 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)



3.8 Types of information requestedIn Q2 2012 the most common types of information requested were regarding the topics of maternal and child health, constipation and drugs and alcohol (Table 11).

Type of information requested

1 Maternal and child health

2 Constipation

3 Drugs and alcohol

4 Feeding: solids

5 Feeding: bottle

6 Feeding: breast

7 Hospital facilities

8 Sleep: 6 months +

9 Crying baby

10 Teeth development and teething

11 Sleep: 0 - 3 months

12 Family welfare

13 Parenting: about babies

14 Pregnancy: eating well

15 Sleeping: 3 - 6 months

16 Pregnancy: common problems

17 Child health: new mums

18 Pregnancy: morning sickness

19 General counselling: adults / family / relationships

20 Child development: 0 - 3 months

Table 11: Top 20 types of information requested (pregnancy, birth & baby helpline)

Note this information is a combination of fact sheet and service directory data.



Aboriginal / Torres Strait Islander 1.4


Declined 17.5

Table 10: Cultural background (pregnancy, birth & baby helpline)

3.7 Interpreter and hearing servicesThree callers required the services of an interpreter and no callers required hearing assistance services.

“In Q2 2012 10.1% of calls to the pregnancy, birth & baby helpline were made by fathers on behalf of a child

18 I pregnancy, birth & baby helpline

3.9 AdviceIn Q2 2012 the most common types of advice or recommendations given were ‘Referral to a nurse’ (70.3%), ‘Supply of pregnancy and perinatal fact sheet’ (9.8%) and ‘Health provider contact details’ (7.3%) (Table 12).


Referral to a nurse 70.3

Supply of pregnancy and perinatal fact sheets 9.8

Health provider contact details 7.3

General counselling 7.0

Referred back to a treating medical professional 2.1

Referral to a pregnancy / perinatal support agency 1.3

Pregnancy counselling 1.3

Counselling: enquiry neg.

Activate Triple Zero (000) neg.

Table 12: Recommendation / advice (pregnancy, birth & baby helpline)

“In Q2 2012 the most popular time for calls to the pregnancy, birth & baby helpline was 6.00pm

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