Associations Between Degree-of-worry, Self-rated Health and Acute Hospitalisation After Contacting a Medical Helpline: a Danish Prospective Cohort Study

Overview

Journal BMJ Open

Specialty General Medicine

Date 2021 May 28

PMID 34045212

Citations 1

Authors

Andrea Nedergaard Jensen

Maria Kristiansen

Janne Schurmann Tolstrup

Hejdi Gamst-Jensen

Affiliations

Soon will be listed here.

Abstract

Objectives: Self-rated health (SRH) is a strong predictor for healthcare utilisation among chronically ill patients. However, its association with acute hospitalisation is unclear. Individuals' perception of urgency in acute illness expressed as degree-of-worry (DOW) is however associated with acute hospitalisation. This study examines DOW and SRH, respectively, and their association with acute hospitalisation within 48 hours after calling a medical helpline.

Design: A prospective cohort study.

Setting: The Medical Helpline 1813 (MH1813) in the Capital Region of Denmark, Copenhagen.

Participants: Adult (≥18 years of age) patients and relatives/close friends calling the MH1813 between 24 January and 9 February 2017. A total of 6812 callers were included.

Outcome Measures: The primary outcome measure was acute hospitalisation. Callers rated their DOW (1=minimum worry, 5=maximum worry) and SRH (1=excellent, 5=poor). Covariates included age, sex, Charlson Comorbidity Score and reason for calling. Logistic regression was conducted to measure the associations in three models: (1) crude; (2) age-and-sex-adjusted; (3) full fitted model (age, sex, comorbidity, reason for calling, DOW/SRH).

Results: Of 6812 callers, 492 (7.2%) were acutely hospitalised. Most callers rated their health as being excellent to good (65.3%) and 61% rated their worry to be low (DOW 1-3). Both the association between DOW and acute hospitalisation and SRH and acute hospitalisation indicated a dose-response relationship: DOW 1=ref, 3=1.8 (1.1;3.1), 5=3.5 (2.0;5.9) and SRH 1=ref, 3=0.8 (0.6;1.4), 5=1.6 (1.1;2.4). The association between DOW and acute hospitalisation decreased slightly, when further adjusting for SRH, whereas the estimates for SRH weakened markedly when including DOW.

Conclusions: DOW and poor SRH were associated with acute hospitalisation. However, DOW had a stronger association with hospitalisation than SRH. This suggests that DOW may capture acutely ill patients' perception of urgency better than SRH in relation to acute hospitalisation after calling a medical helpline.

Trial Registration Number: NCT02979457.

Citing Articles

Correlation between illness perceptions and self-reported degree-of-worry in somatic ill patients in emergency care: a Danish cross-sectional study.

Jensen A, Kallemose T, Frostholm L, Gamst-Jensen H BMJ Open. 2024; 14(10):e089595.

PMID: 39486818 PMC: 11529743. DOI: 10.1136/bmjopen-2024-089595.

References

Thygesen S, Christiansen C, Christensen S, Lash T, Sorensen H . The predictive value of ICD-10 diagnostic coding used to assess Charlson comorbidity index conditions in the population-based Danish National Registry of Patients. BMC Med Res Methodol. 2011; 11:83. PMC: 3125388. DOI: 10.1186/1471-2288-11-83. View

Fayers P, Hand D, Bjordal K, Groenvold M . Causal indicators in quality of life research. Qual Life Res. 1997; 6(5):393-406. DOI: 10.1023/a:1018491512095. View

Thilsted S, Egerod I, Lippert F, Gamst-Jensen H . Relation between illness representation and self-reported degree-of-worry in patients calling out-of-hours services: a mixed-methods study in Copenhagen, Denmark. BMJ Open. 2018; 8(9):e020401. PMC: 6144483. DOI: 10.1136/bmjopen-2017-020401. View

Goldstein M, Siegel J, Boyer R . Predicting changes in perceived health status. Am J Public Health. 1984; 74(6):611-4. PMC: 1651661. DOI: 10.2105/ajph.74.6.611. View

Sovso M, Huibers L, Bech B, Christensen H, Christensen M, Christensen E . Acute care pathways for patients calling the out-of-hours services. BMC Health Serv Res. 2020; 20(1):146. PMC: 7045402. DOI: 10.1186/s12913-020-4994-0. View

Gamst-Jensen H, Huibers L, Pedersen K, Christensen E, Ersboll A, Lippert F . Self-rated worry in acute care telephone triage: a mixed-methods study. Br J Gen Pract. 2018; 68(668):e197-e203. PMC: 5819985. DOI: 10.3399/bjgp18X695021. View

Cohen S, Janicki-Deverts D, Doyle W . Self-Rated Health in Healthy Adults and Susceptibility to the Common Cold. Psychosom Med. 2015; 77(9):959-68. PMC: 4643389. DOI: 10.1097/PSY.0000000000000232. View

Tamayo-Fonseca N, Nolasco A, Quesada J, Pereyra-Zamora P, Melchor I, Moncho J . Self-rated health and hospital services use in the Spanish National Health System: a longitudinal study. BMC Health Serv Res. 2015; 15:492. PMC: 4634188. DOI: 10.1186/s12913-015-1158-8. View

Manderbacka K . Examining what self-rated health question is understood to mean by respondents. Scand J Soc Med. 1998; 26(2):145-53. DOI: 10.1177/14034948980260020301. View

10.

Lau B, Kwan J, Cheung K . Overlap of Frailty, Comorbidity, Disability, and Poor Self-Rated Health in Community-Dwelling Near-Centenarians and Centenarians. J Am Geriatr Soc. 2016; 64(4):900-1. DOI: 10.1111/jgs.14063. View

11.

Chandola T, Jenkinson C . Validating self-rated health in different ethnic groups. Ethn Health. 2000; 5(2):151-9. DOI: 10.1080/713667451. View

12.

Idler E, Benyamini Y . Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav. 1997; 38(1):21-37. View

13.

Gamst-Jensen H, Christensen E, Lippert F, Folke F, Egerod I, Huibers L . Self-rated worry is associated with hospital admission in out-of-hours telephone triage - a prospective cohort study. Scand J Trauma Resusc Emerg Med. 2020; 28(1):53. PMC: 7288501. DOI: 10.1186/s13049-020-00743-8. View

14.

Benyamini Y, Idler E, Leventhal H, Leventhal E . Positive affect and function as influences on self-assessments of health: expanding our view beyond illness and disability. J Gerontol B Psychol Sci Soc Sci. 2000; 55(2):P107-16. DOI: 10.1093/geronb/55.2.p107. View

15.

Jylha M . What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Soc Sci Med. 2009; 69(3):307-16. DOI: 10.1016/j.socscimed.2009.05.013. View

16.

Barsky A, Peekna H, Borus J . Somatic symptom reporting in women and men. J Gen Intern Med. 2001; 16(4):266-75. PMC: 1495200. View

17.

Gamst-Jensen H, Christensen E, Lippert F, Folke F, Egerod I, Brabrand M . Impact of caller's degree-of-worry on triage response in out-of-hours telephone consultations: a randomized controlled trial. Scand J Trauma Resusc Emerg Med. 2019; 27(1):44. PMC: 6458647. DOI: 10.1186/s13049-019-0618-2. View

18.

Jang M, Vorderstrasse A . Socioeconomic Status and Racial or Ethnic Differences in Participation: Web-Based Survey. JMIR Res Protoc. 2019; 8(4):e11865. PMC: 6479282. DOI: 10.2196/11865. View

19.

Isaac V, McLachlan C, Baune B, Huang C, Wu C . Poor Self-Rated Health Influences Hospital Service Use in Hospitalized Inpatients With Chronic Conditions in Taiwan. Medicine (Baltimore). 2015; 94(36):e1477. PMC: 4616650. DOI: 10.1097/MD.0000000000001477. View

20.

Blakoe M, Gamst-Jensen H, von Euler-Chelpin M, Christensen H, Moller T . Sociodemographic and health-related determinants for making repeated calls to a medical helpline: a prospective cohort study. BMJ Open. 2019; 9(7):e030173. PMC: 6720138. DOI: 10.1136/bmjopen-2019-030173. View