Realist analysis of whether emergency departments with primary care services generate 'provider-induced demand'.

ABSTRACT:

Background

It is not known whether emergency departments (EDs) with primary care services influence demand for non-urgent care ('provider-induced demand'). We proposed that distinct primary care services in EDs encourages primary care demand, whereas primary care integrated within EDs may be less likely to cause additional demand. We aimed to explore this and explain contexts (C), mechanisms (M) and outcomes (O) influencing demand.

Methods

We used realist evaluation methodology and observed ED service delivery. Twenty-four patients and 106 staff members (including Clinical Directors and General Practitioners) were interviewed at 13 EDs in England and Wales (240 hours of observations across 30 days). Field notes from observations and interviews were analysed by creating 'CMO'

SUBMITTER: McFadzean IJ 

PROVIDER: S-EPMC9450363 | biostudies-literature | 2022 Sep

REPOSITORIES: biostudies-literature