The Limitation of Accessing Hospital Services Due to COVID-19 Pandemic: A Pilot Study of the Telephone Triage to Re-Organize the Access to a Center for Sexual Health in Northwest Italy
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Mastorino, Luca
[1
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Delmonte, Sergio
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Univ Turin, Dept Med Sci, Dermatol Sect, Turin, ItalyUniv Turin, Dept Med Sci, Dermatol Sect, Turin, Italy
Delmonte, Sergio
[1
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Ribero, Simone
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Univ Turin, Dept Med Sci, Dermatol Sect, Turin, ItalyUniv Turin, Dept Med Sci, Dermatol Sect, Turin, Italy
Ribero, Simone
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Quaglino, Pietro
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Testi, Roberto
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ASL Citta Torino, Sexual Hlth Ctr, Dept Prevent, Turin, ItalyUniv Turin, Dept Med Sci, Dermatol Sect, Turin, Italy
Testi, Roberto
[2
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Dal Conte, Ivano
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ASL Citta Torino, Sexual Hlth Ctr, Dept Prevent, Turin, ItalyUniv Turin, Dept Med Sci, Dermatol Sect, Turin, Italy
Dal Conte, Ivano
[2
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[1] Univ Turin, Dept Med Sci, Dermatol Sect, Turin, Italy
[2] ASL Citta Torino, Sexual Hlth Ctr, Dept Prevent, Turin, Italy
BackgroundThe COVID-19 pandemic-related health crisis has imposed measures aimed at reducing the overcrowding of health facilities, by developing telemedicine and by forcing many sexually transmitted infection (STI) clinics to book appointments by telephone. In this work, we evaluate the performance of the nursing telephone triage system, introduced in the major STI center in Northwest Italy, for the adequacy of clinical pathways for of symptomatic STI patients.MethodsFrom January to March 2021, all symptomatic patients wishing to access the CeMuSS center first underwent nurse-led telephone triage. Symptoms suggestive of STIs were further classified into four syndromic presentations: cutaneous neoformations, genital and oral ulcers, anogenital discharge, and finally other dermatological manifestations. All other clinical pictures were properly managed and eventually referred to other centers and not considered in the analysis. During the following medical examinations, the concordance between presumptive syndromic diagnosis and confirmed clinical diagnosis were recorded. Cohen k test was used to assess concordance.ResultsAccording to the Cohen k test, a good concordance between telephone presumptive diagnoses and medical clinical assessment was found (73.79% with a k = 0.611), whereas only a scarcely acceptable concordance between expected and real waiting time was established (75.51%, k = 0.34).ConclusionsConcordance between nursing syndromic diagnosis and syndromic medically confirmed diagnosis is good from a clinical point of view but there is a limitation when considering a public health perspective. An optimal training of nurses may improve the method of telephone triage. For future ongoing emergencies, the implementation of telemedicine with accurate patient management systems is mandatory.
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Kampala Int Univ Western Campus, Sch Allied Hlth Sci, Dept Publ Hlth, Kampala, Uganda
Youth Alliance Reprod Hlth, Goma, DEM REP CONGOKampala Int Univ Western Campus, Sch Allied Hlth Sci, Dept Publ Hlth, Kampala, Uganda
Mambo, Simon Binezero
Sikakulya, Franck Katembo
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Kampala Int Univ Western Campus, Fac Clin Med & Dent, Dept Surg, Kampala, Uganda
Univ Catholique Graben, Fac Med, Butembo, DEM REP CONGOKampala Int Univ Western Campus, Sch Allied Hlth Sci, Dept Publ Hlth, Kampala, Uganda
Sikakulya, Franck Katembo
Ssebuufu, Robinson
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Kampala Int Univ Western Campus, Fac Clin Med & Dent, Dept Surg, Kampala, UgandaKampala Int Univ Western Campus, Sch Allied Hlth Sci, Dept Publ Hlth, Kampala, Uganda
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Kampala Int Univ Western Campus, Fac Clin Med & Dent, Dept Surg, Kampala, UgandaKampala Int Univ Western Campus, Sch Allied Hlth Sci, Dept Publ Hlth, Kampala, Uganda
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Int Comm Red Cross ICRC, Jeanne DArc 326 Bldg,Sidani St, Beirut, LebanonAmer Univ Beirut, Beirut, Lebanon
Benyaich, Aicha
Yaacoub, Sally
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Int Comm Red Cross ICRC, Jeanne DArc 326 Bldg,Sidani St, Beirut, LebanonAmer Univ Beirut, Beirut, Lebanon
Yaacoub, Sally
Rawi, Haya
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Int Comm Red Cross ICRC, Jeanne DArc 326 Bldg,Sidani St, Beirut, LebanonAmer Univ Beirut, Beirut, Lebanon
Rawi, Haya
Truppa, Claudia
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Int Comm Red Cross ICRC, Jeanne DArc 326 Bldg,Sidani St, Beirut, Lebanon
CRIMEDIM Ctr Res & Training Disaster Med Humanita, Novara, ItalyAmer Univ Beirut, Beirut, Lebanon