SynthesisBMC health services research2016
Motives for self-referral to the emergency department: a systematic review of the literature.
Synthesis in BMC health services research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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Who cites it
39 citing papers in PubMed, 1 synthesis or guideline pooled it.
- How do interventions in primary care or in emergency departments impact less urgent patients' emergency care utilization? A systematic review.BMC health services research · 2026Pooled it
- Beyond a Diagnosis: A Qualitative Study Exploring Patient and Caregiver Expectations About Emergency Department Visits Amid Uncertainty.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Article
- Factors associated with avoidable non-urgent emergency department visits in South Tyrol (Italy): a multicentre cross-sectional study.BMC emergency medicine · 2026Article
- Review
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- Characteristics and reasons non-urgent self-referred patients visit the emergency department in Kimberley, South Africa.Health SA = SA Gesondheid · 2025Article
- [Motives of patients presenting independently at the emergency department-a prospective monocentric observational study].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2024Observational
- Emergency care in Brazil: factors leading to clinically inappropriate use of emergency care among young adult users in the Brazilian context.BMC health services research · 2024Article
- The Use of Medical Services for Low-Acuity Emergency Cases in Germany: Protocol for a Multicenter Observational Pilot Study.JMIR research protocols · 2024Article
- A prospective study to evaluate the contribution of the pediatric appendicitis score in the decision process.BMC pediatrics · 2024Article
- Effect of primary health care on the association between multimorbidity and emergency service utilization: National Health Survey, 2019.Revista brasileira de epidemiologia = Brazilian journal of epidemiology · 2024Article
- An integrative review of adult patient-reported reasons for non-urgent use of the emergency department.BMC nursing · 2023Article
- Psychiatric referrals to the general hospital emergency department: are we being effective?Frontiers in psychiatry · 2023Article
- Characteristics of Patients Who Visited Emergency Department: A Nationwide Population-Based Study in South Korea (2016-2018).International journal of environmental research and public health · 2022Article
- Tendency to call an ambulance or attend an emergency department for minor or non-urgent problems: a vignette-based population survey in Britain.Emergency medicine journal : EMJ · 2022Article
- The "better data, better planning" census: a cross-sectional, multi-centre study investigating the factors influencing patient attendance at the emergency department in Ireland.BMC health services research · 2022Article
- Practice variation across five European paediatric emergency departments: a prospective observational study.BMJ open · 2022Observational
- Rural Patients' Perceptions of Their Potentially Preventable Hospitalisation: A Qualitative Study.Journal of patient experience · 2022Article
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Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn several western countries patients' use of Emergency Departments (EDs) is increasing. A substantial number of patients is self-referred, but does not need emergency care. In order to have more influence on unnecessary self-referral, it is essential to know why patients visit the ED without referral. The goal of this systematic review therefore is to explore what motivates self-referred patients in those countries to visit the ED.
methodsRecommendations from the PRISMA were used to search and analyze the literature. The following databases; PUBMED, MEDLINE, EMBASE, CINAHL and Cochrane Library, were systematically searched from inception up to the first of February 2015. The reference lists of the included articles were screened for additional relevant articles. All studies that reported on the motives of self-referred patients to visit an ED were selected. The reasons for self-referral were categorized into seven main themes: health concerns, expected investigations; convenience of the ED; lesser accessibility of primary care; no confidence in general practitioner/primary care; advice from others and financial considerations. A random-effects meta-analysis was performed.
resultsThirty publications were identified from the literature studied. The most reported themes for self-referral were 'health concerns' and 'expected investigations': 36% (95% Confidence Interval 23-50%) and 35% (95% CI 20-51%) respectively. Financial considerations most often played a role in the United States with a reported percentage of 33% versus 4% in other countries (p < 0.001).
conclusionsWorldwide, the most important reasons to self-refer to an ED are health concerns and expected investigations. Financial considerations mainly play a role in the United States.
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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.