Journal article
Which features of primary care affect unscheduled secondary care use? A systematic review
- Abstract:
- OBJECTIVES: To conduct a systematic review to identify studies that describe factors and interventions at primary care practice level that impact on levels of utilisation of unscheduled secondary care. SETTING: Observational studies at primary care practice level. PARTICIPANTS: Studies included people of any age of either sex living in Organisation for Economic Co-operation and Development (OECD) countries with any health condition. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome measure was unscheduled secondary care as measured by emergency department attendance and emergency hospital admissions. RESULTS: 48 papers were identified describing potential influencing features on emergency department visits (n=24 studies) and emergency admissions (n=22 studies). Patient factors associated with both outcomes were increased age, reduced socioeconomic status, lower educational attainment, chronic disease and multimorbidity. Features of primary care affecting unscheduled secondary care were more complex. Being able to see the same healthcare professional reduced unscheduled secondary care. Generally, better access was associated with reduced unscheduled care in the USA. Proximity to healthcare provision influenced patterns of use. Evidence relating to quality of care was limited and mixed. CONCLUSIONS: The majority of research was from different healthcare systems and limited in the extent to which it can inform policy. However, there is evidence that continuity of care is associated with reduced emergency department attendance and emergency hospital admissions.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 1.1MB, Terms of use)
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- Publisher copy:
- 10.1136/bmjopen-2013-004746
Authors
- Publisher:
- BMJ Publishing Group
- Journal:
- BMJ Open More from this journal
- Publication date:
- 2014-05-23
- Acceptance date:
- 2014-04-23
- DOI:
- EISSN:
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2044-6055
- Language:
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English
- Keywords:
- Pubs id:
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466137
- UUID:
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uuid:11494f08-2f0f-4e8a-92fa-0a480bf285c2
- Local pid:
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pubs:466137
- Source identifiers:
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466137
- Deposit date:
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2014-06-16
- ARK identifier:
Terms of use
- Copyright holder:
- Huntley et al
- Copyright date:
- 2014
- Notes:
- © 2014 Huntley et al. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.
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