{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T07:40:16Z","timestamp":1783496416621,"version":"3.55.0"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T00:00:00Z","timestamp":1730419200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T00:00:00Z","timestamp":1730419200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Boras"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>To effectively utilize available healthcare resources, integrated care models are recommended. According to such model\u2019s, registered nurses have the potential to increase patient access to health care services and alleviate organizational workload. Studies on acute home consultation assessments by registered nurses are sparse. The aim was to describe the reasons and actions for unscheduled same-day face-to-face registered nurse consultation at home offered to patients calling the national telephone helpline for healthcare in Sweden (SHD 1177), according to the integrated Collaborative Health Care model.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A descriptive cross-sectional study was designed. Data from registered nurses (<jats:italic>n<\/jats:italic>\u2009=\u2009259) working within the Collaborative Health Care model, who performed unscheduled consultations at home (<jats:italic>n<\/jats:italic>\u2009=\u2009615) using a data collection tool from 2017 to 2018 were collected.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Among the 615 unscheduled home consultations performed by registered nurses, &gt;\u200950% of the patients were managed at home as their health problems were not deemed as requiring a same-day referral to a clinic when assessed by the registered nurses. The most frequent health problems and reasons for contact were urinary tract problems, followed by medical and surgical conditions. Social factors, including living alone, impacted referral. Those living with a partner received care at home to a greater extent than those who lived alone.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>An integrated model for healthcare involving registered nurses direct assessment, action and accountability seems to be an efficient option for providing integrated care at home and reducing acute clinic visits.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12913-024-11643-3","type":"journal-article","created":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T20:02:11Z","timestamp":1730491331000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Unscheduled home consultations by registered nurses may reduce acute clinic visits"],"prefix":"10.1186","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0530-9408","authenticated-orcid":false,"given":"Karin","family":"Bergman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7067-2687","authenticated-orcid":false,"given":"Lena","family":"Hed\u00e9n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9194-3244","authenticated-orcid":false,"given":"Annelie J","family":"Sundler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7633-482X","authenticated-orcid":false,"given":"Malin","family":"\u00d6stman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1819-0896","authenticated-orcid":false,"given":"Jenny","family":"Hallgren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,11,1]]},"reference":[{"key":"11643_CR1","unstructured":"World Health Organization, editor. WHO global strategy on people-centred and integrated health services: interim report. 2015."},{"key":"11643_CR2","volume-title":"Health Spending Projections to 2030: New results based on a revised OECD methodology","author":"L Lorenzoni","year":"2019","unstructured":"Lorenzoni L, Marino A, Morgan D, James C. Health Spending Projections to 2030: New results based on a revised OECD methodology. 2019."},{"key":"11643_CR3","first-page":"2262","volume-title":"The evolution of the quintuple aim: health equity, health outcomes, and the economy","author":"D Itchhaporia","year":"2021","unstructured":"Itchhaporia D. The evolution of the quintuple aim: health equity, health outcomes, and the economy. In: American College of Cardiology Foundation Washington DC; 2021. pp. 2262\u20134."},{"issue":"1","key":"11643_CR4","doi-asserted-by":"publisher","first-page":"921","DOI":"10.1186\/s12913-023-09932-4","volume":"23","author":"L Emmesj\u00f6","year":"2023","unstructured":"Emmesj\u00f6 L, Gillsj\u00f6 C, Dahl Aslan AK, Hallgren J. Patients\u2019 and next of kin\u2019s expectations and experiences of a mobile integrated care model with a home health care physician\u2013a qualitative thematic study. BMC Health Serv Res. 2023;23(1):921.","journal-title":"BMC Health Serv Res"},{"issue":"4","key":"11643_CR5","doi-asserted-by":"publisher","first-page":"3373","DOI":"10.3390\/ijerph20043373","volume":"20","author":"C Curioni","year":"2023","unstructured":"Curioni C, Silva AC, Dami\u00e3o J, Castro A, Huang M, Barroso T, et al. The cost-effectiveness of Homecare Services for adults and older adults: a systematic review. Int J Environ Res Public Health. 2023;20(4):3373.","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"11643_CR6","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1186\/s12877-023-04373-4","volume":"23","author":"T Knight","year":"2023","unstructured":"Knight T, Kamwa V, Atkin C, Green C, Ragunathan J, Lasserson D, et al. Acute care models for older people living with frailty: a systematic review and taxonomy. BMC Geriatr. 2023;23(1):809.","journal-title":"BMC Geriatr"},{"issue":"4","key":"11643_CR7","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1097\/TME.0000000000000375","volume":"43","author":"J Ruel","year":"2021","unstructured":"Ruel J. Home health care nursing impacts on emergency department utilization. Adv Emerg Nurs J. 2021;43(4):324\u201330.","journal-title":"Adv Emerg Nurs J"},{"key":"11643_CR8","doi-asserted-by":"publisher","unstructured":"Zonneveld N, Driessen N, St\u00fcssgen RAJ, Minkman MMN. Values of integrated care: a systematic review. Int J Integr Care. 18(4):9, 1\u201312. https:\/\/doi.org\/10.5334\/ijic.4172.","DOI":"10.5334\/ijic.4172"},{"issue":"1","key":"11643_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12913-018-3161-3","volume":"18","author":"S Baxter","year":"2018","unstructured":"Baxter S, Johnson M, Chambers D, Sutton A, Goyder E, Booth A. The effects of integrated care: a systematic review of UK and international evidence. BMC Health Serv Res. 2018;18(1):1\u201313.","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"11643_CR10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12913-020-06037-0","volume":"21","author":"J van Vuuren","year":"2021","unstructured":"van Vuuren J, Thomas B, Agarwal G, MacDermott S, Kinsman L, O\u2019Meara P, et al. Reshaping healthcare delivery for elderly patients: the role of community paramedicine; a systematic review. BMC Health Serv Res. 2021;21(1):1\u201315.","journal-title":"BMC Health Serv Res"},{"issue":"3","key":"11643_CR11","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1111\/j.1365-2648.2010.05275.x","volume":"66","author":"RJ Purc-Stephenson","year":"2010","unstructured":"Purc-Stephenson RJ, Thrasher C. Nurses\u2019 experiences with telephone triage and advice: a meta-ethnography. J Adv Nurs. 2010;66(3):482\u201394.","journal-title":"J Adv Nurs"},{"issue":"21\u201322","key":"11643_CR12","doi-asserted-by":"publisher","first-page":"4203","DOI":"10.1111\/jocn.14622","volume":"27","author":"AC Wahlberg","year":"2018","unstructured":"Wahlberg AC, Bj\u00f6rkman A. Expert in nursing care but sometimes disrespected-telenurses\u2019 reflections on their work environment and nursing care. J Clin Nurs. 2018;27(21\u201322):4203\u201311.","journal-title":"J Clin Nurs"},{"issue":"2","key":"11643_CR13","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1177\/1054773806298507","volume":"16","author":"SR Moscato","year":"2007","unstructured":"Moscato SR, Valanis B, Gullion CM, Tanner C, Shapiro SE, Izumi S. Predictors of patient satisfaction with telephone nursing services. Clin Nurs Res. 2007;16(2):119\u201337.","journal-title":"Clin Nurs Res"},{"issue":"2","key":"11643_CR14","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1016\/j.outlook.2014.08.004","volume":"63","author":"J Smolowitz","year":"2015","unstructured":"Smolowitz J, Speakman E, Wojnar D, Whelan E-M, Ulrich S, Hayes C, Wood L. Role of the registered nurse in primary health care: meeting health care needs in the 21st century. Nurs Outlook. 2015;63(2):130\u20136.","journal-title":"Nurs Outlook"},{"issue":"4","key":"11643_CR15","doi-asserted-by":"publisher","first-page":"158","DOI":"10.12968\/pnur.2021.32.4.158","volume":"32","author":"J Lukewich","year":"2021","unstructured":"Lukewich J, Poitras M-E, Mathews M. Unseen, unheard, undervalued: advancing research on registered nurses in primary care. Pract Nurs. 2021;32(4):158\u201362.","journal-title":"Pract Nurs"},{"key":"11643_CR16","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.ijnurstu.2017.05.013","volume":"74","author":"A Norful","year":"2017","unstructured":"Norful A, Martsolf G, de Jacq K, Poghosyan L. Utilization of registered nurses in primary care teams: a systematic review. Int J Nurs Stud. 2017;74:15\u201323.","journal-title":"Int J Nurs Stud"},{"issue":"1","key":"11643_CR17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12913-021-07414-z","volume":"22","author":"J Lukewich","year":"2022","unstructured":"Lukewich J, Martin-Misener R, Norful AA, Poitras M-E, Bryant-Lukosius D, Asghari S, et al. Effectiveness of registered nurses on patient outcomes in primary care: a systematic review. BMC Health Serv Res. 2022;22(1):1\u201334.","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"11643_CR18","doi-asserted-by":"publisher","first-page":"2373541","DOI":"10.1080\/17482631.2024.2373541","volume":"19","author":"J Westerholm","year":"2024","unstructured":"Westerholm J, Gustafsson L-K, S\u00f6derman M. The need for acute assessments in home healthcare-swedish registered nurses\u2019 experiences. Int J Qualitative Stud Health Well-being. 2024;19(1):2373541.","journal-title":"Int J Qualitative Stud Health Well-being"},{"key":"11643_CR19","doi-asserted-by":"publisher","first-page":"101068","DOI":"10.1016\/j.ienj.2021.101068","volume":"59","author":"J Hallgren","year":"2021","unstructured":"Hallgren J, Bergman K, Klingberg M, Gillsj\u00f6 C. Implementing a person centred collaborative health care model \u2013 A qualitative study on patient experiences. Int Emerg Nurs. 2021;59:101068.","journal-title":"Int Emerg Nurs"},{"issue":"9596","key":"11643_CR20","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","volume":"370","author":"E Von Elm","year":"2007","unstructured":"Von Elm E, Altman DG, Egger M, Pocock SJ, G\u00f8tzsche PC, Vandenbroucke JP. The strengthening the reporting of Observational studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370(9596):1453\u20137.","journal-title":"Lancet"},{"issue":"4","key":"11643_CR21","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1111\/nhs.12632","volume":"21","author":"IK Holmstr\u00f6m","year":"2019","unstructured":"Holmstr\u00f6m IK, Gustafsson S, Wesstr\u00f6m J, Skoglund K. Telephone nurses\u2019 use of a decision support system: an observational study. Nurs Health Sci. 2019;21(4):501\u20137.","journal-title":"Nurs Health Sci"},{"key":"11643_CR22","doi-asserted-by":"publisher","first-page":"215013191774718","DOI":"10.1177\/2150131917747186","volume":"9","author":"R Da Borg\u00e8s","year":"2018","unstructured":"Da Borg\u00e8s R, Brault I, Pineault R, Chouinard M-C, Prud\u2019homme A, D\u2019Amour D. Nursing practice in primary care and patients\u2019 experience of care. J Prim Care Community Health. 2018;9:2150131917747186.","journal-title":"J Prim Care Community Health"},{"issue":"3","key":"11643_CR23","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/j.aenj.2011.04.001","volume":"14","author":"L Schnitker","year":"2011","unstructured":"Schnitker L, Martin-Khan M, Beattie E, Gray L. Negative health outcomes and adverse events in older people attending emergency departments: a systematic review. Australasian Emerg Nurs J. 2011;14(3):141\u201362.","journal-title":"Australasian Emerg Nurs J"},{"key":"11643_CR24","doi-asserted-by":"publisher","unstructured":"Lake R, Georgiou A, Li J, Li L, Byrne M, Robinson M, Westbrook JI. The quality, safety and governance of telephone triage and advice services\u2013an overview of evidence from systematic reviews. BMC Health Serv Res. 2017;17:1\u201310. https:\/\/doi.org\/10.1186\/s12913-017-2564-x.","DOI":"10.1186\/s12913-017-2564-x"},{"issue":"2","key":"11643_CR25","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1016\/j.ienj.2011.11.006","volume":"21","author":"B Ek","year":"2013","unstructured":"Ek B, Edstr\u00f6m P, Toutin A, Svedlund M. Reliability of a Swedish pre-hospital dispatch system in prioritizing patients. Int Emerg Nurs. 2013;21(2):143\u20139.","journal-title":"Int Emerg Nurs"},{"issue":"563","key":"11643_CR26","doi-asserted-by":"publisher","first-page":"e209","DOI":"10.3399\/bjgp09X420941","volume":"59","author":"B McKinstry","year":"2009","unstructured":"McKinstry B, Watson P, Pinnock H, Heaney D, Sheikh A. Telephone consulting in primary care: a triangulated qualitative study of patients and providers. Br J Gen Practice: J Royal Coll Gen Practitioners. 2009;59(563):e209\u2013218.","journal-title":"Br J Gen Practice: J Royal Coll Gen Practitioners"},{"issue":"1","key":"11643_CR27","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.eururo.2009.02.026","volume":"56","author":"DE Irwin","year":"2009","unstructured":"Irwin DE, Milsom I, Kopp Z, Abrams P, Artibani W, Herschorn S. Prevalence, severity, and symptom bother of lower urinary tract symptoms among men in the EPIC study: impact of overactive bladder. Eur Urol. 2009;56(1):14\u201320.","journal-title":"Eur Urol"},{"key":"11643_CR28","doi-asserted-by":"publisher","first-page":"237796081881177","DOI":"10.1177\/2377960818811773","volume":"4","author":"AY Zhang","year":"2018","unstructured":"Zhang AY, Xu X. Prevalence, burden, and treatment of lower urinary tract symptoms in men aged 50 and older: a systematic review of the literature. SAGE Open Nurs. 2018;4:2377960818811773.","journal-title":"SAGE Open Nurs"},{"issue":"6","key":"11643_CR29","doi-asserted-by":"publisher","first-page":"e0129875","DOI":"10.1371\/journal.pone.0129875","volume":"10","author":"EPH Choi","year":"2015","unstructured":"Choi EPH, Chin W-Y, Lam CLK, Wan EYF, Chan AKC, Chan KHY. Evaluation of the effectiveness of nurse-led continence care treatments for Chinese primary care patients with lower urinary tract symptoms. PLoS ONE. 2015;10(6):e0129875.","journal-title":"PLoS ONE"},{"key":"11643_CR30","doi-asserted-by":"publisher","unstructured":"Hallgren J, B\u00e4ckstr\u00f6m C, Pettersson M, Sternehov E, Larsson M. A prospective cross-sectional study of child healthcare competence among nurses within primary healthcare in Sweden. Nordic J Nurs Res. 2023;43(1):1\u201311. https:\/\/doi.org\/10.1177\/20571585221096548.","DOI":"10.1177\/20571585221096548"},{"issue":"1","key":"11643_CR31","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12912-020-00413-1","volume":"19","author":"M Claesson","year":"2020","unstructured":"Claesson M, Jonasson L-L, Lindberg E, Josefsson K. What implies registered nurses\u2019 leadership close to older adults in municipal home health care? A systematic review. BMC Nurs. 2020;19(1):1\u201311.","journal-title":"BMC Nurs"},{"issue":"6","key":"11643_CR32","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1016\/j.jamda.2012.04.011","volume":"13","author":"JE Morley","year":"2012","unstructured":"Morley JE. Aging in place. J Am Med Dir Assoc. 2012;13(6):489\u201392.","journal-title":"J Am Med Dir Assoc"},{"issue":"3","key":"11643_CR33","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1177\/08943184211010456","volume":"34","author":"M Holmberg","year":"2021","unstructured":"Holmberg M. The EXPAND-model: a hermeneutical application of a lifeworld-led prehospital emergency nursing care. Nurs Sci Q. 2021;34(3):287\u201393.","journal-title":"Nurs Sci Q"}],"container-title":["BMC Health Services Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-024-11643-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12913-024-11643-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-024-11643-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T20:02:29Z","timestamp":1730491349000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmchealthservres.biomedcentral.com\/articles\/10.1186\/s12913-024-11643-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,1]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["11643"],"URL":"https:\/\/doi.org\/10.1186\/s12913-024-11643-3","relation":{},"ISSN":["1472-6963"],"issn-type":[{"value":"1472-6963","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,1]]},"assertion":[{"value":"22 April 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 September 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 November 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Regional Research Ethics Board in Linkoping, Sweden (DNR: 2017\/376-31).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"At the time of this submission, Professor Annelie J Sundler, is serving as an Editorial Board Member at BMC Nursing. We have no further financial support or relationship that may create a conflict of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1338"}}