SynthesisBMJ open2014
Which features of primary care affect unscheduled secondary care use? A systematic review.
Synthesis in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 117 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
117 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- What helps or hinders the communication of poor prognosis between secondary and primary care? A systematic review with narrative synthesis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Pooled it
- Pooled it
- Prediction models for the prediction of unplanned hospital admissions in community-dwelling older adults: A systematic review.PloS one · 2022Pooled it
- Factors influencing general practitioners decisions to refer Paediatric patients to the emergency department: a systematic review and narrative synthesis.BMC family practice · 2020Pooled it
- Why Do People Choose Emergency and Urgent Care Services? A Rapid Review Utilizing a Systematic Literature Search and Narrative Synthesis.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2017Pooled it
- Pooled it
- A systematic review of the magnitude and cause of geographic variation in unplanned hospital admission rates and length of stay for ambulatory care sensitive conditions.BMC health services research · 2015Pooled it
- Coordination of oral anticoagulant care at hospital discharge (COACHeD): pilot randomised controlled trial.BMJ open · 2024Trial
- Two-year follow-up of a clustered randomised controlled trial of a multicomponent general practice intervention for people at risk of poor health outcomes.BMC health services research · 2024Trial
- General practice staff and patient experiences of a multicomponent intervention for people at high risk of poor health outcomes: a qualitative study.BMC primary care · 2024Trial
- A general practice intervention for people at risk of poor health outcomes: the Flinders QUEST cluster randomised controlled trial and economic evaluation.The Medical journal of Australia · 2022Trial
- Trial
- Frequent attenders in primary health care in Finland: use of primary care services and patient characteristics.Scandinavian journal of primary health care · 2026Article
- Trends in acute specialist contacts following a primary care contact 2012-21-a registry-based study.Scandinavian journal of primary health care · 2026Article
- Which aspects of continuity of care in primary care are associated with better self-rated health? A cross-sectional study among older adults in Berlin.BMC primary care · 2026Article
- Income-related inequalities in ACSC hospitalization in Canada: evidence from 2005-2019 surveys linked with hospitalization and tax data.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- Timeliness, continuity or travel time: results of a choice-based analysis exploring public preferences for access to primary care in Canada.BMC primary care · 2026Article
- Socioeconomic inequality and access to emergency care: understanding the pathways to the emergency department in the UK.BMJ open · 2025Observational
- Lingering Effects on the Ecology of Medical Care After the COVID-19 Pandemic: A Nationwide Repeated Cross-Sectional Study in Japan.Journal of general and family medicine · 2025Article
- Primary Care Utilization and Prehospital Emergency Demand Among Patients with Multimorbidity in Spain.Nursing reports (Pavia, Italy) · 2025Article
57 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
8 authors.
Funding
Abstract
objectivesTo 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.
settingObservational studies at primary care practice level.
participantsStudies 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.
results48 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.
conclusionsThe 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.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.