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Am J Manag Care. 2002 Apr;8(4):343-51.

An analysis of patient compliance with nurse recommendations from an after-hours call center.

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Department of Family Medicine and the Bowen Research Center, Indiana University School of Medicine, Indianapolis 46202-5102, USA.



To demographically and clinically describe the callers who use an after-hours call center (AHCC); to estimate the level of patient satisfaction with the AHCC; to determine caller compliance with the AHCC nurse's recommendation; and to examine the relationship between compliance and selected demographic and clinical characteristics, including caller satisfaction.


A prospective, quasi-experimental telephone survey.


Randomly selected callers (n = 427) to an AHCC were surveyed by telephone to determine their satisfaction with the services provided and their compliance with the AHCC nurse's recommendation.


Overall, 88.2% of the AHCC clients were compliant with the nurse's recommendations. Logistic regression analysis revealed that 2 patient variables had a statistically significant impact on compliance. Patients or their surrogates (eg, parents/guardians, caregivers) who were "very satisfied" were more than 4 times more likely to be compliant, and the surrogates of the patients under the age of 1 year were more than 20 times more likely to be compliant. The greatest level of patient dissatisfaction was with the time it took to make contact with the nurse. Decreasing this response time may improve satisfaction, which in turn may increase compliance and lead to more desirable health outcomes.


The level of compliance was found to be favorable for all levels of acuity. However, the results indicate a further need for quality improvement activities.

[Indexed for MEDLINE]
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