Does parents’ socioeconomic position affect the accuracy of the level of care assigned to their children in out-of-hours primary care? A combined observational and register-based exploratory study in Denmark

Adults with low socioeconomic position (SEP) are often provided poorer healthcare than adults with high SEP. Parents’ SEP affects their children’s health, but the mechanisms of this association remain to be explained. We aimed to explore whether parents’ SEP is associated with the accuracy of the level of care provided to their children following telephone triage in out-of-hour primary care. We performed a combined observational and register-based exploratory study. Tape-recorded telephone calls about children to out-of-hour primary care services in two regions of Denmark were randomly retrieved over a two-week-period in 2016. A panel of assessors evaluated the accuracy of the assigned level of care to each child. We divided the rating into ‘accurate’ and ‘inaccurate’ assigned level of care, including both under-triage and over-triage. We retrieved register data from Statistics Denmark on SEP of the calling parents: ethnicity, educational level, labour market affiliation and household disposable income. We performed logistic regression analyses to examine associations between the socioeconomic parameters and accuracy of the assigned level of care following the telephone triage. We included 382 calls; 89% were evaluated as accurately assigned level of care, and 11% as inaccurately assigned level of care. High educational level (OR = 1.39, 95% CI = 0.59–3.29), high household income (OR = 1.59, 95% CI = 0.64–3.92) and ethnicity (OR = 0.76, 95% CI = 0.35–1.64) were insignificantly associated with accuracy of the assigned level of care, but all pointed in the same direction with children of parents with high SEP having increased likelihood of being assigned to accurate level of care. Our findings are suggestive that SEP of parents might be positively associated with accuracy of assigned level of care when parents call the out-of-hour primary care services. As results were insignificant, the results have to be confirmed in a larger scale study taking the rarity of inaccurate level of care in telephone triage into consideration.