Telephone triage as a strategy to ensure 24-hour access to medical care after the closure of supporting medical activity

The provision of telephone access to a medical officer during nonduty hours was implemented by one Army health clinic to ensure continuous access to cost-efficient care after the closure of its supporting medical activity. After-hours phone calls were tracked for 6 months. Callers were surveyed to determine if use of the system resulted in avoidance of self-referral to civilian medical facilities. A mean of 70 calls per month (186 calls per 1,000 population per year) were placed to the on-call medical officer. Eight types of complaints accounted for more than three-quarters of calls. Fifty percent of callers were seen by the medical officer for an after-hours clinic visit, 38% were given advice for care at home, and 10% were referred to a civilian medical facility. Telephone triage yielded an estimated $8,447 in cost avoidance during a 6-week survey period. Telephone triage can facilitate continuous access to cost-efficient care.