The Library
Realist analysis of whether emergency departments with primary care services generate ‘provider-induced demand’
Tools
Tools
Tools
McFadzean, I. J., Edwards, M., Davies, F., Cooper, A., Price, D., Carson-Stevens, A., Dale, J., Hughes, T., Porter, A., Harrington, B., Evans, B., Siriwardena, N., Anderson, P. and Edwards, A. (2022) Realist analysis of whether emergency departments with primary care services generate ‘provider-induced demand’. BMC Emergency Medicine, 22 (1). 155. doi:10.1186/s12873-022-00709-2 ISSN 1471-227X.
|
PDF
WRAP-Realist-analysis-of-whether-emergency-departments-with-primary-care-services-generate-provider-induced-demand-Dale-2022.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (1081Kb) | Preview |
Official URL: http://dx.doi.org/10.1186/s12873-022-00709-2
Abstract
Background
It is not known whether emergency departments (EDs) with primary care services influence demand for non-urgent care (‘provider-induced demand’). We proposed that distinct primary care services in EDs encourages primary care demand, whereas primary care integrated within EDs may be less likely to cause additional demand. We aimed to explore this and explain contexts (C), mechanisms (M) and outcomes (O) influencing demand.
Methods
We used realist evaluation methodology and observed ED service delivery. Twenty-four patients and 106 staff members (including Clinical Directors and General Practitioners) were interviewed at 13 EDs in England and Wales (240 hours of observations across 30 days). Field notes from observations and interviews were analysed by creating ‘CMO’ configurations to develop and refine theories relating to drivers of demand.
Results
EDs with distinct primary care services were perceived to attract demand for primary care because services were visible, known or enabled direct access to health care services. Other influencing factors included patients’ experiences of accessing primary care, community care capacity, service design and population characteristics.
Conclusions
Patient, local-system and wider-system factors can contribute to additional demand at EDs that include primary care services. Our findings can inform service providers and policymakers in developing strategies to limit the effect of potential influences on additional demand when demand exceeds capacity.
| Item Type: | Journal Article | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Subjects: | R Medicine > RA Public aspects of medicine | ||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Academic Primary Care Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
||||||||
| Library of Congress Subject Headings (LCSH): | Hospitals -- Emergency services -- Evaluation, Emergency medicine, Primary health care, Primary care (Medicine), Emergency medical services | ||||||||
| Journal or Publication Title: | BMC Emergency Medicine | ||||||||
| Publisher: | BioMed Central Ltd. | ||||||||
| ISSN: | 1471-227X | ||||||||
| Official Date: | 6 September 2022 | ||||||||
| Dates: |
|
||||||||
| Volume: | 22 | ||||||||
| Number: | 1 | ||||||||
| Number of Pages: | 11 | ||||||||
| Article Number: | 155 | ||||||||
| DOI: | 10.1186/s12873-022-00709-2 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||||
| Date of first compliant deposit: | 28 September 2022 | ||||||||
| Date of first compliant Open Access: | 29 September 2022 | ||||||||
| RIOXX Funder/Project Grant: |
|
Request changes or add full text files to a record
Repository staff actions (login required)
 |
View Item |
Downloads
Downloads per month over past year
