The Use of Triage in Primary Care in the UK: An Integrative Review and Narrative Synthesis

英国初级保健中分诊的应用:一项综合性综述和叙述性总结

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Abstract

AIMS: To examine the use of triage systems in primary care in the UK. DESIGN: Integrative literature review and narrative synthesis. DATA SOURCES: PubMed, EMBASE, CINAHL and Cochrane Library were searched in October 2024. METHODS: An integrative literature review was conducted following Whittemore and Knafl's (2005) five-step process. Of 1440 articles retrieved, 305 duplicates were removed, and 1086 excluded after title and abstract screening. Two additional articles were identified through citation and hand searches. Twenty studies were quality-assessed using the Mixed Methods Appraisal Tool, and data were extracted for narrative synthesis. RESULTS: Twenty studies were selected, including four randomised controlled trials, three quasi-experimental studies, eleven descriptive studies and two qualitative studies. The most common type of triage was telephone triage, most frequently performed by nurses. The most common health outcomes included subsequent patient re-contacts after triage, patient symptoms or complaints, current health status and patient safety. The benefits of triage included high patient satisfaction, workload redistribution, reduced GP workload and emergency department crowding, improved resource utilisation, access to care and communication. The challenges of triage included increased overall contact time, mis-triage issues, recruitment and retention challenges, the unsuitability of the decision support tool for the primary care setting and lower usage among older and less affluent groups. CONCLUSIONS: This review examined the current use of triage in primary care in the UK, identifying common patterns in triage processes and classifications. Several benefits were identified, though some ongoing concerns about triage remain. IMPACT: This paper provides essential evidence about the current use, effectiveness and challenges of triage in UK primary care. The findings can support healthcare policymakers, practitioners and researchers in planning and improving triage systems. NO PATIENT OR PUBLIC CONTRIBUTION: Integrative review.

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