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Non-emergency department (ED) interventions to reduce ED utilization: a scoping review
Målfrid A Nummedal1, Sarah King2, Oddvar Uleberg2,3,4
1Trondheim Emergency Department Research Group (TEDRG), Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. malfrid.a.nummedal@ntnu.no.
BMC Emergency Medicine
|July 12, 2024
Summary
Non-emergency department (ED) interventions, such as care coordination, can reduce unnecessary ED visits. Research should expand to include older adults and mental health patients to further decrease ED crowding.
Area of Science:
- Health Services Research
- Public Health
- Healthcare Management
Background:
- Emergency department (ED) crowding is a significant global challenge.
- Existing reviews often focus on ED-internal interventions or specific patient groups.
- A comprehensive understanding of non-ED-based strategies is needed to reduce unnecessary ED utilization.
Purpose of the Study:
- To identify, summarize, and categorize non-ED-based interventions aimed at reducing emergency department visits.
- To provide a broad overview of the landscape of interventions outside the ED.
Main Methods:
- A scoping review following JBI Manual for Evidence Synthesis and PRISMA-SCR guidelines.
- Comprehensive literature search in MEDLINE and Embase (2008-March 2024).
- Inclusion of studies reporting on interventions outside the ED targeting ED visit reduction; independent screening and categorization by reviewers.
Main Results:
- 210 studies (183 intervention, 27 systematic reviews) were included from 15,324 records.
- Care coordination/case management and other care programs were the most frequent intervention categories.
- Interventions were primarily located in clinics, homes, hospitals, and primary care settings, often targeting specific medical conditions.
Conclusions:
- Numerous studies investigate interventions to reduce ED patient influx, frequently targeting specific conditions, frequent users, and high-risk individuals.
- Further research is recommended for underrepresented groups like older adults and mental health patients.
- Additional research is needed for low-acuity patients and the general population to reduce overall ED utilization.
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