Tracing the Satisfactory Care of the Chronically Ill in Emergency Departments: A Scoping Review

The growing prevalence of chronic diseases has heightened the demand for emergency department (ED) services, underscoring their increasingly essential role within healthcare systems. To improve outcomes and decrease needless ED use, it is essential to comprehend what constitutes appropriate care in this context.

A scoping review was conducted following PRISMA-ScR reporting guidelines. Relevant studies published between 2013 and 2024 were identified through systematic searches conducted in PubMed, Cochrane and Scopus. The methodological approach was based on the Arksey and O'Malley framework, further refined by Levac et al. and Peters et al., and complemented by the Framework 'N' to integrate principles of caring science and patient-centred care within the synthesis process.

Fifteen studies were deemed eligible for inclusion. Four overarching motifs emerged from the thematic synthesis. (1) Health systems: Age and multimorbidity are the main causes of ED dependence. This emphasises the necessity of service reform and customised care programs. (2) ED use and care transitions: Results are enhanced by functional evaluation, timely pain management and organised follow-up. Delays and disjointed aftercare, however, are frequent. (3) Interdisciplinary collaboration: Coordinated multidisciplinary teams and integration with primary care enhance patient satisfaction and continuity. Nevertheless, these methods are rarely used. (4) Barriers and challenges: Errors, undertreatment and repeated ED visits are caused by stigma, poor staff training, a lack of resources and poor communication.

Stronger integration between emergency departments (EDs) and primary care, along with standardised procedures and individualised care pathways, is essential in response to population aging and the increasing complexity of chronic diseases. Prioritising digital technologies, enhancing staff training and improving care transitions can not only enhance patient outcomes and experiences but also reduce avoidable ED visits.