'Clinically unnecessary' use of emergency and urgent care: A realist review of patients' decision making.

ABSTRACT:

Background

Demand is labelled 'clinically unnecessary' when patients do not need the levels of clinical care or urgency provided by the service they contact.

Objective

To identify programme theories which seek to explain why patients make use of emergency and urgent care that is subsequently judged as clinically unnecessary.

Design

Realist review.

Methods

Papers from four recent systematic reviews of demand for emergency and urgent care, and an updated search to January 2017. Programme theories developed using Context-Mechanism-Outcome chains identified from 32 qualitative studies and tested by exploring their relationship with existing health behaviour theories and 29 quantitative studies.

Results

Six mechanisms, based on ten interrelated programme theo

SUBMITTER: O'Cathain A 

PROVIDER: S-EPMC6978874 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature