SynthesisJournal of general internal medicine2019
Reasons Patients Choose the Emergency Department over Primary Care: a Qualitative Metasynthesis.
Synthesis in Journal of general internal medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers, 1 of them a synthesis 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
64 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
- Emergency department-initiated oral naltrexone for patients with moderate to severe alcohol use disorder: A pilot feasibility study.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2025Trial
- Where's the way out? Access block, boarding and hospital overcrowding: a narrative review.Internal and emergency medicine · 2026Review
- A Qualitative Exploration of Trainee Nurse Practitioners' Experiences and Readiness to Provide Care for Borderline Personality Disorder in Primary Care.International journal of mental health nursing · 2026Article
- Acceptability of HPV self-sampling in three urban academic emergency departments.BMC public health · 2026Article
- Stakeholder perspectives on implementing ED time series forecasting: a qualitative interview study.BMC emergency medicine · 2026Article
- The Registered Nurse Prescriber-Led Triage-Treatment-Continuity Model in Family Medicine: A Practice Innovation and Service Evaluation from Cranston Ridge Medical Clinic.Healthcare (Basel, Switzerland) · 2026Article
- 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
- Applying the Moving Epidemic Method to Emergency Department Syndromic Surveillance to identify the Start of Influenza Seasons in New South Wales, Australia.Influenza and other respiratory viruses · 2026Article
- Evaluation of Health Literacy Levels in Patients in the Emergency Department of a University Hospital: A Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2026Article
- Patient and Caregiver Perspectives on Language Access in Two St. Louis Emergency Departments.Journal of immigrant and minority health · 2026Article
- [Experience of Nursing Professionals with Advanced Practice competencies with triage implementation in Primary Care Emergency Services].Atencion primaria · 2026Article
- Use of an AI-Based Tool (Human Experiences and Reflections Data Connector) to Improve Discovery and Reuse of Archived Qualitative Data: Protocol for an Algorithm Development and Validation Study.JMIR research protocols · 2026Article
- Demographics and costs of pediatric blepharitis and conjunctivitis seen in California emergency departments over a 10-year period.Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus · 2026Article
- Risk for Acute Care Utilization in Housing-Insecure Adults: A National Study of a Hot Spotter Program in the US Veterans Health Administration.Medical care · 2026Article
- Factors Influencing Non-urgent Emergency Department Visits: A Review of the Causes and Impact.Cureus · 2026Review
- Factors associated with avoidable non-urgent emergency department visits in South Tyrol (Italy): a multicentre cross-sectional study.BMC emergency medicine · 2026Article
- Emergency cancer diagnosis in older adults: patterns, subgroups, and implications for health-care quality metrics.JNCI cancer spectrum · 2026Article
- Emergency Department Syndromic Surveillance Diagnostic Code Selection for Assessing Severity of Seasonal Influenza in New South Wales, Australia.Influenza and other respiratory viruses · 2026Article
- Re-evaluating the access imperative in healthcare in the United States.Journal of public health policy · 2026Review
4 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
backgroundTo enhance the acute care delivery system, a comprehensive understanding of the patient's perspectives for seeking care in the emergency department (ED) versus primary care (PC) is necessary.
methodsWe conducted a qualitative metasynthesis on reasons patients seek care in the ED instead of PC. A comprehensive literature search in PubMed, CINAHL, Psych Info, and Web of Science was completed to identify qualitative studies relevant to the research question. Articles were critically appraised using the McMaster University Critical Review Form for Qualitative Studies. We excluded pediatric articles and nonqualitative and mixed-methods studies. The metasynthesis was completed with an interpretive approach using reciprocal translation analyses.
resultsNine articles met criteria for inclusion. Eleven themes under four domains were identified. The first domain was acuity of condition that led to the ED visit. In this domain, themes included pain: "it's urgent because it hurts," and concern for severe illness. The second domain was barriers associated with PC, which included difficulty accessing PC when ill: "my doctor said he was booked up and he instructed me to go to the ED." The third domain was related to multiple advantages associated with ED care: "my doctor cannot do X-rays and laboratory tests, while the ED has all the technical support." In this domain, patients also identified 24/7 accessibility of the ED and no need for an immediate copay at the ED as advantageous. The fourth domain included fulfillment of medical needs. Themes in this domain included the alleviation of pain and the perceived expertise of the ED healthcare providers.
conclusionsIn this qualitative metasynthesis, reasons patients visit the ED over primary care included (1) urgency of the medical condition, (2) barriers to accessing primary care, (3) advantages of the ED, and (4) fulfillment of medical needs and quality of care in the ED.
Indexed as
Identifiers
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.