When a sudden healthcare issue arises, patients aren’t always sure where to seek care. Scheduling an appointment with their primary care provider may take too long. According to a survey Health Dialog conducted, 51% of patients say they can get an appointment with their provider within a week, but 33% have to wait 1-3 plus weeks to be seen. Sometimes waiting isn’t an option but the alternative of visiting the emergency room might be too extreme for a patient’s current situation.
Patients often misjudge their health needs: their symptoms may not feel too severe but, in reality, they’re in the midst of a medical emergency. In fact, according to our internal data, nearly 12% of patients who call our nurse line with a pre-intent of visiting an urgent care facility were appropriately redirected to visit an emergency room instead. On the flip side, 69% of patients with pre-intent to visit the emergency room or call 911 were appropriately redirected to a less emergent level of care. Providing a 24/7 nurse line for patients who need easy and immediate guidance from a trusted resource, like a registered nurse, can help them make the best decision for their healthcare needs.
Health Dialog has a diverse patient base calling our 24/7 nurse line. We analyzed our book of business data to see what the typical caller looks like.* This analysis can help our clients better evaluate their needs for a nurse line and develop promotional campaigns and operational best practices designed to reach patients who hardly use the nurse line—but really should.
*Data has been normalized across Medicare, Medicaid, and Commercial populations.
Who typically calls a nurse line and why?
Almost half of our nurse line callers (47%) have a commercial health insurance plan. Medicaid accounted for almost one third of callers (32%) while Medicare patients use the service the least (21%).
Why are commercial patients using the nurse line more than Medicare or Medicaid patients? In recent years, commercial patients have seen a rise in high-deductible health plans, which means greater out-of-pocket costs. Between 2007-2017, enrollment in high-deductible plans offered by employers with a Health Savings Account (HSA) grew from 4.2% to 18.9%. Without a HSA, the percentage grew from 10.6% to 24.5%. The high and often unknown cost of seeking medical care may be driving patients to call for advice on what to do before digging into their pockets. Medicare patients are using the service the least, suggesting a closer and more ongoing relationship with their provider.
Age & Sex
Roughly 65% of the time, women are placing calls to the nurse line. Men call less often at 35%. The biggest utilizers of the nurse line were callers aged 51-64 at 22%. The second most common age group to call in is 18-35, which represents 20% of callers.
It’s widely understood that women utilize the healthcare system more than men, so it is not surprising they are calling in more often. Women often are the caregivers for families, taking on the responsibility of others’ healthcare needs. Roughly 59% of women report being the caregiver for someone and that number increases to 95% among working mothers.
Wealthy patients are calling in far less often at 18% of the time. Middle class and low-income households make up the majority at 82%.
Income may also play a role. With more disposable income, wealthier patients may not have as many concerns about co-pays or hitting large deductibles. Lower-income patients could be utilizing this service to evaluate if spending their hard-earned money is really a necessity.
Nurse line call rates from suburban and urban areas were similar at 45% and 48% respectively, while rural callers dial in much less often at about 7% of the time.
More calls from an urban area could suggest patients struggle with access to reliable transportation. If your health plan offers rides through a third-party service or a telemedicine vendor as a resource, nurse lines could connect them seamlessly. Providing extra support can help fill gaps that your population may be experiencing. Callers from urban and suburban populations generally have a number of options at their fingertips but sometimes having too many choices can make it tough for patients to make decisions. Calling a nurse line could help them decide if the emergency room, urgent care, or at-home care is the best option for their situation. Rural callers generally have less choices, thus, these patients could take advantage of newer services like telehealth to evaluate their needs and seek treatment without leaving home.
Most calls come in during the week from 9am-6pm. There is not much variation for day of the week.
It can be difficult for patients to get to a doctor during the week. They may not be able to drop everything and get in for an appointment and, that depends if their doctor has appointments available. Patients want a quick and easy option when calling a healthcare professional. Oftentimes, patients are forced to leave messages for their providers and then wait for a nurse to call back. Calling a nurse line eliminates the need for a call back, since patients get instant access to reliable and trusted advice.
People are also busy. Lack of time is a common barrier to care. In one study, 15% of patients reported lack of time as the reason they are avoiding seeking care. There never seems to be enough hours in the day for some, while others may not be able to take vacation time away from work.
The Benefits of Increasing Nurse Line Utilization
Despite who is calling in or when, a nurse line can help patients make the best decision for their healthcare needs. This in turn can help health plans, at-risk providers, and other healthcare organizations ensure the appropriate use of benefits and resources and reduce the overall cost of managing a population.
Regardless of what demographic a patient falls into, it is important to remember that without effectively communicating the benefits of a nurse line, it won’t be utilized to its full potential. Promotion is key for nurse lines to become a top-of-mind resource to all patients. Prominently displaying the service on ID cards, patient portals, and newsletters can help keep this resource in mind. It’s important to use simple and easy-to-understand language when promoting services – especially for those who may be non-native English speakers.
Want to see the full results of the analysis discussed here? Check out our infographic: https://insights.healthdialog.com/infographics/increasing-access-to-care-with-24-7-nurse-lines
Interested in implementing a 24/7 nurse line for your organization? Learn how much a nurse line may cost.