Use of the telephone in a health maintenance service for the chronically ill: A preliminary report

Abstract

EMPHASIS on comprehensive health care shifts the management of many acute and chronic conditions to the ambulatory services. In 1969, of 7144 registered hospitals, 6041 hospitals reported 163,248,221 clinic visits by non-hospitalized patients [I, Table 33. Much of the traditional bedside observation, diagnosis, and care is now performed in outpatient clinics. Patients bear their stresses, whether physical or functional, in the clinics one day and in their own environment the next. The goal and magnitude of ambulatory service stimulates the staff toward developing a care delivery system which can reach the patients in their immediate environment. To monitor patients’ conditions and to extend care needed from the hospital clinics, public health nursing and extramural agencies function in a partnership that creates a health service milieu. If the patients’ progress, stresses, and coping patterns are to be brought into focus, effective communication is imperative. Such communication includes face-to-face interaction as well as that transmitted through written and other technological means. A number of studies have reported on the use of the telephone as an aid in diagnosis and prevention in patient care. Some of these were concerned with monitoring physical changes only [2, 31. The telephone as a medium for transmitting the sounds of children’s respiratory distress and mothers’ anxieties was reported by Kravitz et al [4]. A study conducted at the Children’s Hospital, Boston [5], analyzed the use of the telephone by low-income families. The findings demonstrated equal effectiveness among medically indigent and middle class families in the use of the telephone to communicate a child’s condition. Besides, such communication enhanced the on-going relationship between the families and the physician. In suicide prevention work 16-81, the emergency telephone number is frequently reported as