Does Registration of Professionals Improve the Quality of Travelers’ Health Advice?

Abstract

The objectives of the Dutch National Coordination Center for Travelers' Health Advice (LCR) are to improve the uniformity of travelers' health advice in the Netherlands and to enhance its quality. The LCR offers national guidelines and quality criteria, as well as a telephone consultation service, where health professionals can pose questions regarding travel medicine. Since 2005, a register for qualified travel health professionals has been in place. We studied the quality and relevance of the telephone consultations, to see whether there was a difference between registered as qualified and nonregistered health professionals. Telephone questions regarding pretravel advice were logged in September 2007. The questions were categorized as basic or advanced and compared by the profession of the caller, type of institution, and LCR registration of the responsible physician. In 2007, 85% of travel clinic physicians, 42% of general practitioners, and 31% of travel clinic nurses were registered with the LCR. A total of 146 telephone consultations were included in the analysis. Significantly more callers from travel clinics posed advanced questions than those from general practices [odds ratio (OR) 7.6; 95% confidence interval (CI): 3.6-16.1; p= 0.000]. More callers who were registered asked advanced questions, although this difference was not significant (OR 1.7; 95% CI: 0.9-3.3; p= 0.124). Assistants from general practices asked significantly less advanced questions than physicians or nurses. Opening a register for travel health professionals has led to a large increase of professionals who follow courses and register as travel health professionals. A positive association was found between the quality of the questions and the registration of the responsible physician. The quality of travel health advice given in general practices needs increased attention.