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Why Do People Choose Emergency and Urgent Care Services? A Rapid Review Utilizing a Systematic Literature Search and Narrative Synthesis
Open accessAbstract
Objectives: Rising demand for emergency and urgent care services is well documented, as are the consequences, for example, emergency department ( ED ) crowding, increased costs, pressure on services, and waiting times. Multiple factors have been suggested to explain why demand is increasing, including an aging population, rising number of people with multiple chronic conditions, and behavioral changes relating to how people choose to access health services. The aim of this systematic mapping review was to bring together published research from urgent and emergency care settings to identify drivers that underpin patient decisions to access urgent and emergency care. Methods: Systematic searches were conducted across Medline (via Ovid SP ), EMBASE (via Ovid), The Cochrane Library (via Wiley Online Library), Web of Science (via the Web of Knowledge), and the Cumulative Index to Nursing and Allied Health Literature ( CINAHL ; via EBSCO host). Peer‐reviewed studies written in English that reported reasons for accessing or choosing emergency or urgent care services and were published between 1995 and 2016 were included. Data were extracted and reasons for choosing emergency and urgent care were identified and mapped. Thematic analysis was used to identify themes and findings were reported qualitatively using framework‐based narrative synthesis. Results: Thirty‐eight studies were identified that met the inclusion criteria. Most studies were set in the United Kingdom (39.4%) or the United States (34.2%) and reported results relating to ED (68.4%). Thirty‐nine percent of studies utilized qualitative or mixed research designs. Our thematic analysis identified six broad themes that summarized reasons why patients chose to access ED or urgent care. These were access to and confidence in primary care; perceived urgency, anxiety, and the value of reassurance from emergency‐based services; views of family, friends, or healthcare professionals; convenience (location, not having to make appointment, and opening hours); individual patient factors (e.g., cost); and perceived need for emergency medical services or hospital care, treatment, or investigations. Conclusions: We identified six distinct reasons explaining why patients choose to access emergency and urgent care services: limited access to or confidence in primary care; patient perceived urgency; convenience; views of family, friends, or other health professionals; and a belief that their condition required the resources and facilities offered by a particular healthcare provider. There is a need to examine demand from a whole system perspective to gain better understanding of demand for different parts of the emergency and urgent care system and the characteristics of patients within each sector.
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“there is existing evidence that some older adults prefer visiting the ED, even when they have a primary care provider.”
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Metadata
- Authors
- Coster, J. E., Turner, J. K., Bradbury, D., & Cantrell, A.
- Affiliations
- University of Sheffield (GB)
- Northampton General Hospital NHS Trust (GB)
- Corresponding author
- Coster, Joanne E.
- Venue
- Academic Emergency Medicine
- Publisher
- Wiley
- Published
- 2017-06-19
- Volume
- 24
- Issue
- 9
- Pages
- 1137-1149
- ISSN
- 1069-6563 (ISSN-L)
- 1553-2712
- PMC
- PMC5599959
- OpenAlex
- W2613680655
- Cited by
- 379
- References
- 74
- Citations by year
- 2026: 34 · 2025: 45 · 2024: 52 · 2023: 55 · 2022: 59 · 2021: 53 · 2020: 45 · 2019: 30 · 2018: 5 · 2017: 1
- FWCI
- 5.66
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Academic Emergency Medicine (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- Funders
- National Institute for Health Research (13/05/12)
- Health Services and Delivery Research Programme
- University of Sheffield
- Topics
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
- Health Sciences › Medicine › Emergency Medicine › Emergency Medicine Education and Research
- Keywords
- emergency department utilization, urgent care, patient help-seeking behavior, primary care access, perceived urgency, convenience, health care costs, emergency department overcrowding, health care demand
- MeSH terms
- Ambulatory Care, Attitude to Health, Choice Behavior, Decision Making, Emergencies, Emergency Service, Hospital, Health Services Accessibility, Health Services Needs and Demand, Humans, Primary Health Care, Qualitative Research, Patient Preference
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